Fatal Cleistanthus collinus Toxicity: A Case Report and Review of Literature
Corresponding Author
Siddhartha Das M.B.B.S., M.D.
Department of Forensic Medicine & Toxicology, JIPMER, Puducherry, 605006 India
Additional information and reprint requests:
Siddhartha Das, M.B.B.S., M.D.
Assistant Professor
Department of Forensic Medicine & Toxicology
JIPMER
Puducherry 605006
India
E-mails: [email protected]; [email protected]
Search for more papers by this authorAbdoul Hamide M.B.B.S., M.D.
Department of General Medicine, JIPMER, Puducherry, 605006 India
Search for more papers by this authorManoj K. Mohanty M.B.B.S., M.D.
Department of Forensic Medicine & Toxicology, JIPMER, Puducherry, 605006 India
Search for more papers by this authorRavichandran Muthusamy M.Sc., M.Phil.
Department of Food & Drugs Testing, Gorimedu, Puducherry, 605006 India
Search for more papers by this authorCorresponding Author
Siddhartha Das M.B.B.S., M.D.
Department of Forensic Medicine & Toxicology, JIPMER, Puducherry, 605006 India
Additional information and reprint requests:
Siddhartha Das, M.B.B.S., M.D.
Assistant Professor
Department of Forensic Medicine & Toxicology
JIPMER
Puducherry 605006
India
E-mails: [email protected]; [email protected]
Search for more papers by this authorAbdoul Hamide M.B.B.S., M.D.
Department of General Medicine, JIPMER, Puducherry, 605006 India
Search for more papers by this authorManoj K. Mohanty M.B.B.S., M.D.
Department of Forensic Medicine & Toxicology, JIPMER, Puducherry, 605006 India
Search for more papers by this authorRavichandran Muthusamy M.Sc., M.Phil.
Department of Food & Drugs Testing, Gorimedu, Puducherry, 605006 India
Search for more papers by this authorAbstract
Cleistanthus collinus is an extremely toxic plant poison. We report a case of suicidal ingestion of boiled water decoction of C. collinus where the patient presented with abdominal pain and giddiness. There was persistent metabolic acidosis and fluctuation in the level of serum potassium. The ECG changes indicated a probable myocardial injury with conduction abnormality. At autopsy, the viscera were found to be congested. The toxins were detected in the viscera and blood by TLC and HPLC. Cleistanthin A and B, collinusin, and diphyllin are the principal toxic constituents of the plant. Consumption of a boiled decoction of leaves is highly toxic and, medical management of patients is mainly supportive because the molecular mechanisms of toxin action are unknown. In the recent years, C. collinus has created a considerable amount of interest because of its complex metabolites and their cytotoxic activities. Through this study, the authors have tried to highlight different properties pertaining to C. collinus.
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