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Plant Poisoning, Castor Bean and Jequirity Bean
Updated: Nov 21, 2008
Introduction
Background
Although castor and jequirity beans are an uncommon cause of poisoning, they remain a concern because their toxins are among the most lethal naturally occurring toxins known today. The beans most commonly are used for ornamental purposes, such as prayer or rosary beads, or in musical shakers (maracas).
The castor bean plant (Ricinus communis) is found primarily in Asia and Africa, but the plant has taken root in all temperate and subtropical regions around the world.
Castor bush.
In fact, the castor bean plant grows in the southwest United States mainly along streams and riverbeds. Castor beans are oblong and brown in color with speckled dark brown spot.
Castor beans.
Jequirity bean plant (Abrus precatorius) is primarily found in southeast Asia, but has spread to subtropical regions.
Jequirity bush.
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The jequirity bean has a shiny appearance and is mainly red in color with a black spot.
Jequirity beans.
For centuries, ricin and abrin, the toxin contained in the seeds of the castor and jequirity beans, respectively, have been used for homicidal purposes. The ease of production of ricin makes it very attractive as an agent that could be used by a terrorist or other criminal. The Centers for Disease Control and Prevention (CDC) categorizes ricin as a category B agent because it is moderately easy to disseminate while causing moderate-to-high morbidity in humans.
During the 1980s, the Iraqi government made weapon-grade ricin, and it was tested on animals and in artillery shells. In 2003, ricin was found in US Senator Bill Frist's office, and, in January of that same year, Arabs connected to Al-Qaeda were arrested in a London apartment while trying to manufacture ricin.1 In February 2008, a man was poisoned in a hotel room in Las Vegas, Nevada. Because of the ongoing threat of weapons of mass destruction (WMD) in the United States, physicians must become familiar with the diagnosis and treatment of poisonings due to substances such as ricin.
Pathophysiology
These beans contain potent toxalbumins that inhibit protein synthesis and cause severe cytotoxic effects on multiple organ systems. Castor beans contain the toxalbumin ricin, and jequirity beans contain abrin. The toxins are present in all parts of the plant but are most concentrated in the beans or seeds. Symptoms include delayed gastroenteritis, which may be severe and hemorrhagic, followed by delirium, seizures, coma, and death. The beans are covered by a hard, relatively impervious outer shell that must be chewed or broken in some way in order for the toxalbumin to be released and, thus, present a toxic hazard. Castor beans are particularly antigenic and may cause severe cutaneous hypersensitivity and systemic reactions.
Frequency
United States
Jequirity and castor bean ingestions are extremely uncommon. The American Association of Poison Control Centers (AAPCC) recorded 168 cases of toxalbumin cases.2 Of those 156 were single exposures, 53 of which were treated in a health care facility. No deaths were reported and only one was considered to have a major adverse reaction.
Mortality/Morbidity
Fatalities have occasionally been reported following ingestion of chewed castor beans. Chewing and swallowing as little as 1 bean may produce death in a child; however, swallowing an intact bean without chewing is unlikely to cause serious sequelae. Jequirity bean mortality is 5% for ingestion, and death may occur as long as 14 days after poisoning.
Clinical
History
- Assess the usual significant features that are associated with toxic environmental exposures. This includes the following:
- Identification of substance
- Time and duration of exposure
- Symptoms
- Treatment thus far
- Associated injuries
- Preexisting conditions
- Identification
- Ask the parents to bring in a sample of the bean, if it is possible. Having the exact bean greatly aids in the identification process.
- Knowing that beans are often known by various names, both common and scientific, is important.
- Time and duration of exposure: Determine whether the child chewed or swallowed any beans.
- Symptomatology
- Following ingestion of jequirity beans, a latent period of about 3 days occurs, and symptoms may persist more than 10 days later. Patient may present with nausea, vomiting, diarrhea, abdominal cramps, hematemesis, and melena. In some cases, acute renal failure and hepatotoxicity may occur.
- Drowsiness and seizures have been reported after jequirity bean ingestion. If eye contact is made, the patient may report eye irritation and blindness. Skin contact may result in a rash.
- Following ingestion of castor beans, the patient may become symptomatic from 8-24 hours after exposure. The clinical picture may appear very similar to jequirity bean ingestion, with GI symptoms that can progress to hypotension, liver and renal failure, and death.
- Inhalation of castor bean toxin can cause illness within 8 hours. Symptoms include cough, dyspnea, arthralgias, fever, respiratory distress, and death. Injection of ricin causes symptoms within 6 hours, which may include weakness and myalgias with progression of the illness to fever, hypotension, multiorgan failure, and death.
- Prior treatment: Determine if any treatment has been administered to the child prior to presentation.
- Associated injuries: Inquire about any other potential exposures or injury.
- Preexisting conditions: Inquire about past medical history, medications, and allergies.
Physical
- Assess airway patency. It is extremely uncommon to have any oral or upper airway swelling of sufficient magnitude to cause airway compromise. Breathing usually is unaffected. Circulation may become affected as shock develops, secondary to severe gastroenteritis.
- Patients may develop severe cutaneous hypersensitivity or systemic allergic reactions. An urticarial, immunoglobulin E–mediated allergic reaction may occur with the development of tongue or facial swelling, bronchospasm, and acute upper airway obstruction.
Causes
- Both castor and jequirity beans are commonly encountered as ornamental beans or seeds.
- Castor and jequirity beans are commonly used as prayer beads, bracelets, or necklaces.
- Castor and jequirity beans are also used as the seeds that rattle in maracas.
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| References |
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References
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Further Reading
Keywords
castor bean, caster bean plant, caster bean seeds, caster bean poison, jequirity bean, terrorism, ricin, gastroenteritis
