Abstract
Infective etiologies are the first differentials that come to the mind in clinical conditions presenting with diarrhea associated with encephalopathy. We report a case of a 21 year old lady diagnosed as acute infective gastroenteritis and treated for the same only to manifest itself later as encephalopathy leading to a diagnostic dilemma. The clinical manifestations had started from abdominal cramps, bloody diarrhea followed by altered sensorium. A detailed history later revealed the use of the roots of Abrus precatorius for the treatment of sub-fertility was the missing piece of the diagnostic puzzle. Only after confirmation of the herb did the temporal sequence of events seemed logical. The patient was successfully managed for toxic acute disseminated encephalomyelitis (ADEM). Abrus precatorius is a commonly used herb used in traditional medicinal practice in many cultures. Various aspects of its toxicity can mimic other more commonly encountered medical ailments.
Highlights
Many infective organisms have been known to cause acute gastroenteritis associated with encephalopathy.[1]
We present a case of Abrus precatorius toxicity presenting with features of acute gastroenteritis followed by demyelinating encephalopathy which was successfully treated with steroids with no residual sequelae
The most common uses of this herb are for eye problems like conjunctivitis, gastrointestinal problems, fever, and uterine problems including dysmenorrhoea,urticaria, eczema, stomatitis, alopecia areata, migraine, malaria,schistosomiasis, and lymphomas/ leukemia and is used even as a laxative, expectorant and aphrodisiac.[4,5,6]
Summary
Many infective organisms have been known to cause acute gastroenteritis associated with encephalopathy.[1] Infective causes are the first differentials that come to the mind when faced with such a clinical scenario. Anti-ribosomal toxins, abrin and ricin from the plant Abrus precatorius exhibit series of gastrointestinal disturbances like abdominal cramps, bloody diarrhea and vomiting.[2] In rare cases, central nervous system (CNS) features of raised ICP, drowsiness, seizures, encephalitis and even death have been reported.[3]. We present a case of Abrus precatorius toxicity presenting with features of acute gastroenteritis followed by demyelinating encephalopathy which was successfully treated with steroids with no residual sequelae. Written informed consent was taken from the patient for the publication of this case report
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
