From folk remedy to toxic emergency: a case of acute abrin toxicity

Abrus precatorius (rosary pea) contains abrin, a highly potent ribosome-inhibiting toxin. Its seeds are well-known to be toxic when chewed or crushed, while boiled seed decoctions are occasionally used in traditional medicine.

We report a case of a 42-year-old male who developed gastrointestinal symptoms after ingesting decoction of 500 ml boiled water containing 50 g of Abrus precatorius seeds as a folk remedy. Despite the significant seed quantity, only the boiled water was consumed, not the seeds themselves. The patient presented with persistent vomiting and abdominal pain but remained hemodynamically stable and had normal laboratory findings. He was successfully managed with supportive care and discharged after 24 hours with no complications.

This case highlights that ingestion of Abrus precatorius decoction, without seed ingestion, may lead to mild toxicity. Awareness of such traditional practices is critical for early diagnosis and appropriate management.