Wooten Joe Valentine, Pittman Christopher T, Blake Thomas A, Thomas Jerry D, Devlin John J, Higgerson Renee A, Johnson Rudolph C
National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA,
J Med Toxicol. 2014 Dec;10(4):392-4. doi: 10.1007/s13181-013-0377-9.
The seeds of Abrus precatorius contain the highly toxic plant protein abrin. There is no antidote for abrin poisoning. Management, largely supportive, may consist of administering intravenous fluids, anti-emetics, and activated charcoal depending on the time of exposure. We report the presentation of a single case of unintentional abrin poisoning confirmed by the quantitation of L-abrine biomarker.
A previously healthy 22-month-old, 11.5-kg female presented to the hospital after ingesting approximately 20 rosary peas (A. precatorius) sold as a "peace bracelet". Her primary manifestations were episodes of forceful emesis that included food particles progressing to clear gastric fluid. The patient was tachycardic (HR = 134 bpm) but had brisk capillary refill and normal blood pressure (96/60 mmHg). Laboratory testing revealed elevated blood urea nitrogen (16 mg/dL) and serum creatinine (0.4 mg/dL). In the emergency department, the patient was resuscitated with 40 mL/kg normal saline via peripheral IV and received ondansetron (0.15 mg/kg IV) to control retching. The patient was discharged well 24 h after the ingestion.
This is the first case of human abrin toxin poisoning confirmed by the quantitation of L-abrine as a biomarker. Quantifying the levels of abrin toxin in the body after exposure can help clinicians make informed decisions when managing patients with symptomatic exposures to seeds of A. precatorius.
相思子种子含有剧毒植物蛋白相思子毒素。相思子毒素中毒没有解毒剂。治疗主要是支持性的，根据接触时间，可能包括静脉输液、止吐药和活性炭。我们报告了一例通过定量L-相思子毒素生物标志物确诊的意外相思子毒素中毒病例。
一名先前健康的22个月大、体重11.5千克的女性，在食用了约20颗作为“平安手链”出售的相思子后被送往医院。她的主要表现是强力呕吐发作，最初吐出食物颗粒，后来吐出清亮胃液。患者心动过速（心率 = 134次/分钟），但毛细血管再充盈良好，血压正常（96/60毫米汞柱）。实验室检查显示血尿素氮升高（16毫克/分升）和血清肌酐升高（0.4毫克/分升）。在急诊科，通过外周静脉给予患者40毫升/千克生理盐水进行复苏，并给予昂丹司琼（0.15毫克/千克静脉注射）以控制干呕。摄入后24小时患者康复出院。
这是首例通过定量L-相思子毒素作为生物标志物确诊的人类相思子毒素中毒病例。接触后定量体内相思子毒素水平有助于临床医生在处理有症状接触相思子种子的患者时做出明智决策。
