Podophyllin Toxicity: Case Report of a Rare Poisoning

Podophyllin poisoning is a rare but serious emergency, often fatal, that involves multiple systems, predominantly the nervous system. Usually, it results from the resin extract derived from certain plants, and podophyllotoxin is the most toxic chemical present in it. The toxicity mechanisms involve suppression of cellular nucleoside transport and microtubule disruption. Due to the delayed onset of symptoms, there can be a delay in diagnosing and treating the condition. In addition, the initial and dominant central nervous system (CNS) symptoms can be mistaken for CNS infection or brainstem stroke. Therefore, early diagnosis (based on a high degree of suspicion, and circumstantial evidence) and prompt treatment (primarily decontamination and supportive care) are crucial to prevent unfavorable outcomes. We present a rare case of a 23-year-old male who accidentally ingested podophyllin and initially experienced severe neurological symptoms, subsequently developing into multisystem involvement and culminating in death within 4 days of its ingestion.