Ricin and abrin are related toxins derived from ornamental beans that can cause multi-organ failure and death. Both toxins inhibit protein synthesis, and proteins associated with the source beans can cause anaphylaxis. They can be used as inhalational or gastrointestinal agents for mass exposures. They are most potent when administered parenterally.
Poison |
Source |
Genus and Species |
ricin |
castor bean |
Ricinus communis |
abrin |
jequirity bean |
Abrus precatorius |
Respiratory symptoms - prominent with inhalational exposures:
(1) cough
(2) dyspnea
(3) pulmonary edema
(4) tachypnea
(5) respiratory failure
Gastrointestinal symptoms - prominent with ingestion:
(1) nausea and vomiting
(2) profuse diarrhea with dehydration and electrolyte depletion
(3) colicky abdominal pain
(4) gastrointestinal bleeding
(5) pancreatitis
General symptoms:
(1) fever
(2) influenza-like symptoms with myalgia and arthralgias
(3) weakness
(4) malaise
CNS findings:
(1) headache
(2) lethargy
(3) convulsions
(4) coma
(5) peripheral neuropathy (late)
(6) confusion
(7) neuropsychological changes
Cardiovascular findings:
(1) tachycardia
(2) hypotension
(3) ECG changes in ST segment and T wave
(4) shock
Genitourinary findings:
(1) hemoglobinuria
(2) oliguria and renal failure
Hematologic findings:
(1) hemolytic anemia
(2) abnormal red cells morphology (basophilic stippling, Heinz bodies)
(3) thrombocytopenia
Hepatic changes:
(1) abnormal liver function tests
(2) hepatitis
Immune changes:
(1) allergic dermatitis
(2) rhinitis
(3) asthma
(4) anaphylaxis
In severe cases death may occur 36-72 hours after exposure.
Criteria for diagnosis:
(1) identification of ricin or abrin in plasma or urine or in environmental samples
(2) absence of any other condition that could explain the findings
(3) clinical findings compatible with ricin or abrin exposure
Specialty: Toxicology, Emergency Medicine, Critical Care
ICD-10: ,