Anticholinergic toxicity in a one-year-old male following ingestion of Lupinus mutabilis seeds
case report
Keywords:
Lupinus, Foodborne diseases, Anticholinergic syndrome, Cholinergic antagonists, AlkaloidsAbstract
CONTEXT: The seeds from Lupinus mutabilis Sweet, also called “chocho”, are an important part of the diet in several countries in South America. Prior to consumption, processing is required to remove toxic alkaloids. These alkaloids are known to have pharmacological properties as antiarrhythmics, antimuscarinics and hypoglycemics. CASE REPORT: We report a case in which a one-year-old male initially presented with altered mental status and respiratory distress and subsequently developed symptoms of anticholinergic toxicity, after ingesting a large amount of chocho seeds. CONCLUSION: In spite of going through a difficult clinical condition, the subject evolved favorably through receiving supportive treatment. The seeds from Lupinus mutabilis provide nutritional ben- efits when consumed, but people need to know their risks when these seeds are consumed without proper preparation.
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References
Fine JS. Poisoning. In: McInerny TK, Adam HM, Campbell DE, et al., editors. American Academy of Pediatrics Textbook of Pediatric Care. 2nd edition. Chicago: American Academy of Pediatrics; 2016. Chapter 369.
Carter K, Neuspiel DR. Toxic plants. Pediatr Rev. 2010;31(4):174-5.
Jacobsen SE, Mujica A. Geographical distribution of the Andean lupin (Lupinus mutabilis Sweet). PGR Newsletter. 2008;155:1-8. Available from: http://www.bioversityinternational.org/fileadmin/PGR/article-issue_155-art_1-lang_es.html. Accessed in 2017 (Jul 18).
Jacobsen SE, Mujica A. El tarwi (Lupinus mutabilis Sweet.) y sus parientes silvestres. Botánica Económica de los Andes Centrales. 2006;458-82. Available from: http://www.beisa.dk/Publications/BEISA%20Book%20pdfer/Capitulo%2028.pdf. Accessed in 2017 (Jul 18).
Villacres E, Peralta E, Cuadrado L, et al. Propiedades y aplicaciones de los alcaloides del chocho (Lupinus mutabilis Sweet). INIAP ESPOCH SENACYT. Quito: Editorial Grafistas; 2008.
Camacho Saavedra L, Uribe Uribe L. Intoxicación por agua de Lupinus mutabilis (“Chocho”) [Lupinus mutabilis’s water intoxication]. Bol Soc Peru Med Interna. 1995;8(3/4):35-7.
Ortega Duarte A, Martin-Sánchez FJ, Gonzales Castillo J, Ruiz Artacho P. Intoxicación por “agua de chocho” [Lupinus mutabilis (chocho) water intoxication]. Medicina Clínica. 2012;140(1):43-4. Available from: http://www.elsevier.es/es-revista-medicina-clinica-2-articulo-intoxicacion-por-agua-chocho-S0025775312005374. Accessed in 2017 (Jul 18).
Pingault NM, Gibbs RA, Barclay AM, Monaghan M. Two cases of anticholinergic syndrome associated with consumption of bitter lupin flour. Med J Aust. 2009;191(3):173-4.
Litkey J, Dailey MW. Anticholinergic toxicity associated with the ingestion of lupini beans. Am J Emerg Med. 2007;25(2):215-7.
Jamali S. Dilated pupils, dry mouth and dizziness - a case study. Aust Fam Physician. 2011;40(10):789-90.
Fornasini M, Castro J, Villacrés E, et al. Hypoglycemic effect of Lupinus mutabilis in healthy volunteers and subjects with dysglycemia. Nutr Hosp. 2012;27(2):425-33.
Baldeón ME, Castro J, Villacrés E, Narváez L, Fornasini M. Hypoglycemic effect of cooked Lupinus mutabilis and its purified alkaloids in subjects with type-2 diabetes. Nutr Hosp. 2012;27(4):1261-6.
