Clinical and laboratory findings in patients with castor bean (Ricinus communis L.) poisoning referred to Imam Reza hospital in northeast of Iran, from April 2015 to March 2020

Moshiri, Mohammad; Ramazani, Yeganeh; Akhgari, Nilofar; Dadpour, Bita; Etemad, Leila

doi:10.22038/ajp.2025.26942

Clinical and laboratory findings in patients with castor bean (Ricinus communis L.) poisoning referred to Imam Reza hospital in northeast of Iran, from April 2015 to March 2020

Articles in Press

Document Type : Short communication

Authors

Mohammad Moshiri ¹

Yeganeh Ramazani ²

Nilofar Akhgari ²

Bita Dadpour ¹

Leila Etemad ³

¹ Medical Toxicology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

² Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

³ Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

10.22038/ajp.2025.26942

Abstract

Objective: Castor bean (CB) (Ricinus communis) contains a highly toxic natural compound called ricin. We retrospectively reviewed the documents of CB-poisoned cases referred to the clinical toxicology department of Imam Reza Hospital affiliated with Mashhad University of Medical Sciences, Mashhad, Iran.
Materials and Methods: Patients’ data including epidemiological variables, rout and amount of CB ingestion, clinical and laboratory findings, and type of treatment were extracted from hospital documents.
Results: Twelve cases of CB ingestion, with mean age 29.42±21.19 years (4 to 70 years), 4 children (33.3%), and two elderly people (16.7%), were included in the study. All of them were intoxicated by oral ingestion of CB. The mean number of ingested CBs was 4.83±3.16 seeds (range 1-10, median 5 seeds). The most common complaint of the cases (n=11, 91.67%) was frequent vomiting, followed by nausea (n=7, 41.7%) and diarrhea (n=4, 33.3%). Vomiting more commonly occurred up to the second hour after seeds ingestion and at a frequency of 8 to 21 times. The vital signs of all cases were in normal ranges and no tachycardia, hypotension, or tachypnea was recorded. Also, all laboratory results were normal, except metabolic acidosis (pH 7.3) in one case (8.3%). All cases were discharged in good condition with conservative treatment after 19.5±15.3 hr (12-45 hr, median=22 hr). None of them reported any problem in follow-up.
Conclusion: The majority of our cases were mild. Gastrointestinal problems, especially frequent vomiting, were the most common complaints. Conservative management was effective in mild to moderate cases.

Keywords

Ricin

Castor Bean

Herbal

Poisoning

Vomiting

Subjects