Alhamdani Mazin, Brown Brande, Narula Pramod
Department of Pediatrics, New York Methodist Hospital, Brooklyn, NY, USA.
Am J Case Rep. 2015 Mar 10;16:146-8. doi: 10.12659/AJCR.892917.
When discussing known poisons and their clinical consequences, few physicians are aware of the deadly poison abrin. The common symptoms of abrin toxicity include nausea, vomiting, abdominal pain, and diarrhea with or without bloody stool. However, with an estimated fatal human dose of less than 1 microgram/kg, death due to complications such as liver failure, renal failure, and cerebral edema are possible.
An 18-month-old male presented to the emergency department with an abrupt onset of fever, vomiting, diarrhea, and dehydration. The parents had assumed the child was suffering from a severe gastroenteritis until they noticed 3 consecutive diapers containing colorful seeds that were identified by poison control as belonging to the Abrus precatorius plant. The child's gastrointestinal symptoms were consistent with reported cases of abrin poisoning, but the patient also had an isolated and significantly elevated alkaline phosphatase, with testing unable to reveal the responsible pathological process.
To reduce morbidity and possible mortality, parents and pediatricians alike should be conscious of the danger the Abrus precatorius seed poses to the pediatric population. Children are at a greater risk of ingesting these seeds due to their colorful appearance, and the consequences could be fatal. Through this case report we hope to raise public awareness regarding this toxin. This includes the management of known cases, as well as the possibility of encountering an isolated elevated alkaline phosphatase level as a laboratory finding if ingestion occurs.
在讨论已知毒物及其临床后果时，很少有医生了解致命毒物相思子毒素。相思子毒素中毒的常见症状包括恶心、呕吐、腹痛和腹泻，可伴有或不伴有血便。然而，据估计，人类的致死剂量小于1微克/千克，因肝功能衰竭、肾功能衰竭和脑水肿等并发症导致死亡是有可能的。
一名18个月大的男性因突然发热、呕吐、腹泻和脱水被送往急诊科。父母最初认为孩子患有严重肠胃炎，直到他们注意到连续3片尿布上有彩色种子，经毒物控制中心鉴定，这些种子属于相思子植物。孩子的胃肠道症状与报道的相思子毒素中毒病例一致，但患者还出现了孤立且显著升高的碱性磷酸酶，检查未能揭示其相关病理过程。
为降低发病率和可能的死亡率，家长和儿科医生都应意识到相思子种子对儿童群体构成的危险。由于其外观色彩鲜艳，儿童误食这些种子的风险更大，后果可能是致命的。通过本病例报告，我们希望提高公众对这种毒素的认识。这包括对已知病例的处理，以及如果发生误食，可能会出现孤立的碱性磷酸酶水平升高作为实验室检查结果的情况。
