Hebrew
Albanian
Arabic
Armenian
Azerbaijani
Belarusian
Bengali
Bosnian
Catalan
Czech
Danish
Deutsch
Dutch
English
Estonian
Finnish
Français
Greek
Haitian Creole
Hebrew
Hindi
Hungarian
Icelandic
Indonesian
Irish
Italian
Japanese
Korean
Latvian
Lithuanian
Macedonian
Mongolian
Norwegian
Persian
Polish
Portuguese
Romanian
Russian
Serbian
Slovak
Slovenian
Spanish
Swahili
Swedish
Turkish
Ukrainian
Vietnamese
Български
中文(简体)
中文(繁體)
Clinical Toxicology 2020-Jun

Near-fatal poisoning after ricin injection

רק משתמשים רשומים יכולים לתרגם מאמרים
התחבר הרשם
הקישור נשמר בלוח
Fábio Bucaretchi
Carla Borrasca-Fernandes
Camila Prado
Rafael Lanaro
José Costa
Otávio Petroni
Tiago Giraldi
Maria Blotta
Amauri Justo-Junior
Natália Sousa

מילות מפתח

תַקצִיר

Objective: To report a near-fatal poisoning after intentional injection of ricin from a castor bean (Ricinus communis) extract.Case report: A 21 year-old man self-injected ∼3 mL of a castor bean extract intramuscularly and subcutaneously in the left antecubital fossa. Upon admission to our ED (1 h post-exposure; day 1, D1) he was awake and alert, but complained of mild local pain and showed slight local edema and erythema. He evolved to refractory shock (∼24 h post-exposure) that required the administration of a large volume of fluids and high doses of norepinephrine and vasopressin, mainly from D2 to D4. During this period, he developed clinical and laboratory features compatible with systemic inflammatory response syndrome, multiple organ dysfunction, capillary leak syndrome, rhabdomyolysis, necrotizing fasciitis and possible compartment syndrome. The patient underwent forearm fasciotomy on D4 and there was progressive improvement of the hemodynamic status from D7 onwards. Wound management involved several debridements, broad-spectrum antibiotics and two skin grafts. Major laboratory findings within 12 days post-exposure revealed hypoalbuminemia, proteinuria, thrombocytopenia, leukocytosis and increases in cytokines (IL-6, IL-10 and TNF-α), troponin and creatine kinase. Ricin A-chain (ELISA) was detected in serum up to D3 (peak at 24 h post-exposure), with ∼79% being excreted in the urine within 64 h post-exposure. Ricinine was detected in serum and urine by LC-MS up to D5. A ricin A-chain concentration of 246 µg/mL was found in the seed extract, corresponding to the injection of ∼738 µg of ricin A-chain (∼10.5 µg/kg). The patient was discharged on D71, with limited range of motion and function of the left forearm and hand.Conclusion: Ricin injection resulted in a near-fatal poisoning that evolved with septic shock-like syndrome, multiple organ dysfunction and necrotizing fasciitis, all of which were successfully treated with supportive care.

Keywords: Castor seeds; necrotizing fasciitis; ricin; ricinine; systemic inflammatory response syndrome.

הצטרפו לדף הפייסבוק שלנו

המאגר השלם ביותר של צמחי מרפא המגובה על ידי המדע

  • עובד ב 55 שפות
  • מרפא צמחי מרפא מגובה על ידי מדע
  • זיהוי עשבי תיבול על ידי דימוי
  • מפת GPS אינטראקטיבית - תייגו עשבי תיבול במיקום (בקרוב)
  • קרא פרסומים מדעיים הקשורים לחיפוש שלך
  • חפש עשבי מרפא על פי השפעותיהם
  • ארגן את תחומי העניין שלך והתעדכן במחקר החדשות, הניסויים הקליניים והפטנטים

הקלד סימפטום או מחלה וקרא על צמחי מרפא שעשויים לעזור, הקלד עשב וראה מחלות ותסמינים שהוא משמש נגד.
* כל המידע מבוסס על מחקר מדעי שפורסם

Google Play badgeApp Store badge