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Attempted suicide, by mail order: Abrus precatorius.

David H Jang¹, Robert S Hoffman, Lewis S Nelson

¹New York City Poison Control Center, New York University, New York, NY, USA. Jangd01@nyumc.org

Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology

|June 22, 2010

Summary

A man survived ingesting Abrus precatorius seeds, a potent poison, after ordering them online. Prompt identification and supportive care were crucial for his recovery from abrin toxicity.

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Area of Science:

Toxicology
Plant-based toxins
Accidental and intentional poisoning

Background:

Abrus precatorius seeds contain abrin, a highly toxic protein inhibiting protein synthesis.
Abrin's estimated human fatal dose is extremely low (0.1-1 μg/kg).
Intentional ingestion via online purchase presents a unique public health challenge.

Observation:

A 20-year-old man presented with severe vomiting and diarrhea after chewing and swallowing 10 Abrus precatorius seeds.
The seeds were identified via an image sent to a poison control center, enabling targeted management.
The patient admitted to ordering the seeds online for a suicide attempt after reading about them on the internet.

Findings:

Chewing Abrus precatorius seeds releases abrin, causing gastrointestinal distress and potential hypovolemia and electrolyte disturbances.
Despite the high toxicity of abrin, the patient recovered with supportive care over two days.
Intact seed ingestion typically results in no symptoms due to their hard shells, but chewing significantly increases risk.

Implications:

Online accessibility of lethal plant toxins like abrin poses significant risks.
Rapid identification and supportive care are critical for managing abrin poisoning.
Public awareness and education regarding the dangers of Abrus precatorius seeds are essential.