Gloriosa superba poisoning mimicking an acute infection- a case report

BMC Clinical Pharmacology

H Janaka de Silva¹  Nuwan. P. Premawardana²  Mindu S. Weerasinghe²  Ranjan Premaratna¹ 

[1] Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka;University Medical Unit, Teaching Hospital Ragama, Ragama, Sri Lanka

关键词: Poisoning;    Febrile illness;    Alopecia;    Hair loss;    Gloriosa superba;   

Others  :  1228272
DOI  :  10.1186/s40360-015-0029-6

 received in 2015-06-28, accepted in 2015-09-22,  发布年份 2015

【 摘 要 】

Background

Gloriosa superba (GSb) is a highly poisonous plant and its toxicity is due to anti-mitotic effects of constituents such as colchicine and gloriosine on rapidly proliferating cells. Poisoning is known to cause very rapid and severe clinical manifestations due gastro intestinal, neurological, cardiac and bone marrow toxicity.

Case presentation

A young male presented with an acute onset febrile illness associated with diarrhoea, confusion, haematuria and aggressive behavior of 4 days duration. He developed subconjunctival haemorrhages, bleeding gums, neck stiffness, bilateral papilloedema, tender hepatomegaly and features suggestive of subacute intestinal obstruction. He had progressive reduction in white cell counts, platelets and derrangements in liver functions. The illness mimicked acute severe leptospirosis or dengue. On day 9 of illness he started to loose his hair and was totally alopecic by day 14. At this stage of illness, possibility of GSb poisoning was suspected. He admitted the act of self harm after repeated questioning.

Conclusion

His presentation mimicked an acute severe tropical febrile illness such as leptospirosis or dengue until he started to loose his hair. Therefore we feel that Clinicians practicing in tropical setting where Gloriosa superba is endemic should be aware of its clinical presentations and should always consider the possibility of ingestion of Gloriosa superba when the patient has pancytopenia and develops shedding of hairs which results in total alopecia in a case of unexplained gastroenterocolitis, rather investigating.

【 授权许可】

   
2015 Premaratna et al.

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【 参考文献 】

• [1]Kavithamani D, Umadevi M, Geetha S. A review on Gloriosa superba as a medical plant. Indian J Res Pharm Biotechnol. 2013; 1:554-7.
• [2]Samanta AK, Kumar UK. Poisoning by Glory lilly – a case report. J Indian Acad Forensic Med. 2005; 27:0971-3.
• [3]Peranantham S, Manigandan G, Shanmugam K. Fatal Gloriosa superba poisoning – a case report. IJMPS. 2014; 4(10):21-4.
• [4]Angunawela RM, Fernando HA. “Acute ascending polyneuropathy and dermatitis following poisoning by tubers of G. superba”. Ceylon Medical J. 1971; 16:233-5.
• [5]Mendis S. Colchicine cardiotoxicity following ingestion of Gloriosa superba tubers. Department of Medicine, Faculty of Medicine, Peradeniya, Sri Lanka. Postgrad Med J. 1989; 65:752-5.
• [6]Gooneratne BWM. Massive generalized alopecia after poisoning by GSb superba. Br Med J. 1966; 1(5494):1023-4.
• [7]Fernando R, Fernando D. Poisoning with plants and mushrooms in Sri Lanka: a retrospective hospital based study. Vet Hum Toxicol. 1990; 32:579-81.
• [8]Senthilkumaran S, Balamurugan N, Rajesh N, Thirumalaikolundusubramanian P. Hard facts about loose stools-Massive alopecia in Gloriosa superba poisoning. Int J Trichology. 2011; 3:126-7.