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[麻疯树中毒:向巴黎和马赛毒物中心报告的24例病例]

[Poisoning with Jatropha curcas: 24 cases reported to Paris and Marseille Poisons Centers].

作者信息

Langrand J, Médernach C, Schmitt C, Blanc-Brisset I, Villa A F, de Haro L, Garnier R

机构信息

Centre antipoison de Paris, AP-HP Hôpital Lariboisière, Paris, France,

出版信息

Bull Soc Pathol Exot. 2015 Mar;108(2):139-43. doi: 10.1007/s13149-014-0412-3. Epub 2015 Jan 20.

Abstract

Jatropha curcas L. is an inedible plant belonging to the Euphorbiaceae family that is growing in subtropical zones of all continents. We report a series of 24 cases of poisoning with J. curcas seeds or fruits reported to poison centers in Paris and Marseille between December 2000 and June 2014. Fifteen adults and 9 children ingested J. curcas seeds or fruits. All patients experienced gastrointestinal disorders, within the first hours following ingestion: nausea, vomiting, diarrhea and abdominal pain. Laboratory investigations performed in 10 patients revealed minor abnormalities: CK elevation (8 cases), dehydration (5 cases) with moderate elevation of serum creatinine levels (3 cases), and mildly increased serum bilirubin (8 cases). Complete remission of all clinical signs was observed within 48 hours in the 20 cases for which the outcome was known. Previously published cases of J. curcas poisoning were very similar to ours: As in our series, gastrointestinal disorders were always present. They were sometimes associated with neurological or cardiovascular signs, and hepatic or renal disorders; these were generally interpreted as complications of severe gastroenteritis, although direct toxic effects could not be formally excluded. In most cases, simple supportive measures were sufficient to ensure complete recovery within 24-48 hours. J Curcas poisoning incidence is certainly increasing because the plant is cultivated to produce biodiesel and is now largely present in most subtropical countries. As a consequence, local health professionals should be informed of the toxic properties of this plant.

摘要

麻疯树是一种不可食用的植物,属于大戟科,生长在各大洲的亚热带地区。我们报告了2000年12月至2014年6月期间向巴黎和马赛的中毒控制中心报告的一系列24例麻疯树种子或果实中毒事件。15名成人和9名儿童摄入了麻疯树种子或果实。所有患者在摄入后的最初几个小时内都出现了胃肠道紊乱症状:恶心、呕吐、腹泻和腹痛。对10名患者进行的实验室检查显示有轻微异常:肌酸激酶升高(8例)、脱水(5例)伴血清肌酐水平中度升高(3例)以及血清胆红素轻度升高(8例)。在已知结局的20例患者中,48小时内所有临床症状均完全缓解。先前发表的麻疯树中毒病例与我们的非常相似:与我们的系列病例一样,胃肠道紊乱症状总是存在。它们有时与神经或心血管症状以及肝脏或肾脏疾病相关;这些通常被解释为严重肠胃炎的并发症,尽管不能完全排除直接毒性作用。在大多数情况下,简单的支持性措施足以确保在24至48小时内完全康复。麻疯树中毒的发生率肯定在上升,因为这种植物被用于生产生物柴油,现在在大多数亚热带国家广泛种植。因此,当地卫生专业人员应该了解这种植物的毒性特性。

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