Consuming the seeds or seedlings of the common cocklebur (Xanthium strumarium) can be fatal.
Toxin: carboxyatractyloside
Clinical findings:
(1) nausea and vomiting
(2) altered mental status that may progress to coma
(3) sweating
(4) toxic hepatitis with elevated serum transaminases and total bilirubin
(5) abdominal pain and/or diarrhea
(6) coagulopathy
(7) dyspnea
(8) palpitations
(9) seizures
(10) acute renal failure with proximal tubular necrosis
(11) hyponatremia
(12) hypoglycemia
Death is usually associated with multi-organ failure.
Risk factors for death:
(1) high dose of seeds or seedlings
(2) age <= 15 years
