source, mechanism of poisoning, diagnosis, treatment and differential diagnosis of castor poisoning

1. Castor poisoning

2. • Source: Seeds of Ricinus communis(castor oil plant), the
residues(press cake), entire plant is poisonous
• Mode of transmission: oral, inhalation and injection
Castor plant Press cake

3. Mechanism of action
• Ricin is a glycoprotein composed of A chain and B chain linked by
disulfide bond.
. B chain binds to galactose containing
glycoprotein and glycolipid expressed on
the surface of the cells, facilitating the
entry of ricin into cytosol.
A chain inhibits the protein synthesis by
irreversibly inactivating eukaryotic
ribosomes through removal of a single
adenine residue from the 28S ribosomal
RNA loop contained within the 60S
subunit. This process prevents chain
elongation of polypeptides and leads to
cell death.
B chain A chain

4. Clinical signs
• Intravascular hemolysis
• Uremia
• Burning pain in mouth, throat, and abdomen
• Nausea, severe hematemesis and diarrhoea with or without blood
• Fluid loss – hypotension and shock
• Dehydration
• Cramps
• Seizures

5. Diagnosis
a. On the basis of sign and symptoms.
b. Postmorten changes include focal hemorrhage in the intestines, brain,
myocardium and pleura.
c. Animal inoculation (in mouse, the animal dies within 24 hours).
d. Lab diagnosis: detection of ricin in tissue sections nasal swabs and fluids by
immunologically based methods.

6. Treatment
• Early use of emetics
• Ascorbic acid increases survival rates
• Forced alkaline diuresis prevents nephrosis
• Supportive treatment for hypotension; IV fluid, electrolytes and vasopressors(eg,
dopamine).
• Activated charcoal
• Gastric lavage

7. Differential diagnosis
• Disease causing septicemia
• Other plant poisonings