Death due to kodalikkizhangu poisoning: A case report

Abstract

Deaths due to accidental ingestion, suicidal consumption and homicide poisoning with colchicine alkaloid containing extracts have been documented and reported in innumerable literature across the world. The lowest reported lethal dose of oral colchicine are 7-26 mg. Gloriosa superba, regionally known as Kodalikkizhangu is a highly poisonous flowering plant, seen wide spread in south and south East Asia. Colchicine is concentrated in the seeds and tubers of the plant. Colchicine content of Gloriosa tuber is 0.3%. These tubers are often mistaken as yams and accidentally ingested. Ingestion of tubers of Gloriosa results in colchicine poisoning. Toxicity of Gloriosa is due to the anti-mitotic effect of its toxic principle namely colchicine and Gloriosin on the rapidly proliferating cells such as stomach and oesophagus. Cardiac manifestation of Gloriosa poisoning is due to the impaired cardio myocyte conduction and contractility. Deaths in these cases are due to multi-organ failure. No specific antidote is available. A 71-year-old male who was a chronic alcoholic and known hypertensive got admitted in toxicology ward, with symptoms of acute gastroenteritis, 11 hours after alleged consumption of tubers of a wild plant. 24 hours after ingestion the patient succumbed to death and post-mortem was done to establish cause of death.