Cycas revoluta (sago cycad) exposures reported to Texas poison centers

Cycas revoluta (sago cycad or palm) is a popular ornamental plant in the United States. All parts of the plant contain toxins such cycasin and beta-methylamino-l-alanine, the ingestion of which can be harmful to humans and animals. The objective of this study was to characterize C. revoluta exposures reported to poison centers.

Cases were C. revoluta exposures reported to Texas poison centers during 2000-2018. The distribution of cases by selected variables was determined.

Of 192 total C. revoluta exposures, the most common exposure routes were ingestion (55.7%) and dermal (34.4%). The patient age distribution was 28.1% 5 years or less, 15.1% 6-12 years, 4.7% 13-19 years, and 50.5% 20 years or more; 55.2% were male. The exposure was unintentional in 92.2% of the cases and occurred at the patient's own residence in 94.8%. The patient was managed on site in 78.6% of the cases, already at/en route to a healthcare facility in 12.0%, and referred to a healthcare facility in 8.9%. The most common reported clinical effects were dermal (23.4%), particularly puncture/wound (16.1%), dermal irritation/pain (14.6%), and edema (8.9%), followed by gastrointestinal (13.0%), particularly vomiting (8.9%) and nausea (7.8%).

Most of the C. revoluta exposures tended to be unintentional and occurred at home. Although most of the C. revoluta exposures involved ingestion, 35% were dermal, and the most frequently reported clinical effects were dermal followed by gastrointestinal. Most of the exposures were not serious and were managed outside of a healthcare facility.