P49: Collective poisoning by Atractylis gummifera L., Morocco

Abstract

Introduction The thistle glue or Atractylis gummifera, known in Morocco under the name of “Addad” or “Dad” is a very poisonous plant. It is the leading cause of death from plant poisoning in Morocco. We report the case of collective poisoning by Atractylis gummifera of nine children. Cases report Nine children (5 boys and 4 girls) aged between 8 and 12 years, who participated in the collection of Atractylis gummifera L. following the request of an herbalist. All have consumed this plant in varying quantities. These children were then present signs of poisoning varying severity ranging from simple gastrointestinal signs (vomiting, abdominal pain and headache) to death, 4 children had a convulsive coma and hepatocellular failure. Biological test have objectified elevated transaminase levels ranging from 64 to 8200 IU/L and decreased prothrombin time and disruption of glucose with metabolic acidosis. A beginning toxicological research of Atractylis gummifera by colorimetric method has objectified the presence of trace of glucoside in gastric fluid in two children. Further research by thin layer chromatography with UV exposure lamp 360 nm confirmed the presence of the atractyloside in gastric fluid of the two children with traces in two other children. Children were hospitalized in intensive care with symptomatic treatment and administration of N-acetylcysteine. The outcome was unfortunately marked by the death of 2 children and good clinical and biological improvement for the other seven children. Conclusion Atractylis gummefera poisoning is frequent in the pediatric population in our country and can cause serious poisoning incidents with fatal outcome in many cases. It usually occurs in accidental circumstances having regard to the lack of knowledge of the toxicity of this plant.