[Anticholinergic syndrome after intoxication by lupine seeds (Tourmos)]

Yellow lupine seeds (Tourmos) are frequently used as snack in Lebanon but their potential toxicity is extremely rare (five published cases) and often undiagnosed.

Two patients presented with anticholinergic syndrome (mydriasis, mouth dryness, palpitations, general malaise) after ingestion of 200-500 g of bitter lupine seeds (not soaked enough in water). No other cause of intoxication was found, and symptoms disappeared spontaneously in 24-36h.

Yellow lupine seeds need a long preparation (boiling then soaking with several changes of water) to debitter before consumption. The spontaneous bitter taste is mainly due to the presence of a toxic substance with anticholinergic properties, lupanine. An insufficient preparation or a preference for bitter lupin can result in intoxication.