Hung Y-M, Hung S-Y, Olson K R, Chou K-J, Lin S-L, Chung H-M, Tung C-N, Chang J-C
Division of Nephrology, Hui-Teh Hospital, Taipei, Taiwan.
Intern Med J. 2007 Feb;37(2):130-2. doi: 10.1111/j.1445-5994.2007.01245.x.
Yam bean is a common food in southern Taiwan. However, its seeds are rarely consumed. We describe five patients of yam bean seed poisoning in Taiwan, one of them life-threatening.
The five patients presented with perioral numbness, nausea and vomiting after eating a same soup made from yam bean seeds. One of them, a 54-year-old woman, had difficulty breathing and lost consciousness. Physical examination showed dilated pupils and coma with no focal neurological signs. The initial blood pressure was normal. Laboratory data showed a severe anion gap metabolic acidosis, with a serum lactate level of 185 mg/dL. An initial diagnosis of cyanide intoxication was considered and she was given sodium nitrite and sodium thiosulfate i.v. Hypotension ensued shortly afterwards and pulmonary artery catheterization showed a decreased cardiac index. Aggressive fluid and inotropic therapy were given and the patient eventually recovered. The other four patients suffered only minor gastrointestinal and neurological symptoms and received supportive treatment. Cyanide levels were negative in all five patients.
Yam bean seed poisoning can cause acute metabolic acidosis and altered mental status, which could be confused with acute cyanide intoxication from a cyanogenic glycoside-containing plant. To our knowledge, this is the first outbreak of yam bean seed poisoning reported in the English published work.
豆薯是台湾南部的常见食物。然而，其种子很少被食用。我们描述了台湾5例豆薯种子中毒患者，其中1例危及生命。
这5例患者在食用了用豆薯种子制作的同一汤品后，出现了口周麻木、恶心和呕吐症状。其中1例54岁女性出现呼吸困难并失去意识。体格检查显示瞳孔散大、昏迷，无局灶性神经体征。初始血压正常。实验室检查显示严重的阴离子间隙代谢性酸中毒，血清乳酸水平为185mg/dL。初步诊断考虑为氰化物中毒，给予静脉注射亚硝酸钠和硫代硫酸钠。此后不久出现低血压，肺动脉导管检查显示心脏指数降低。给予积极的液体和强心治疗，患者最终康复。其他4例患者仅出现轻微的胃肠道和神经系统症状，接受了支持治疗。5例患者的氰化物水平均为阴性。
豆薯种子中毒可导致急性代谢性酸中毒和精神状态改变，这可能与含氰苷植物引起的急性氰化物中毒相混淆。据我们所知，这是英文发表作品中首次报道的豆薯种子中毒暴发。
