# Abrin Poisoning Case Study: Rosary Pea Seed Toxicology
> A clinical toxicology case study covering mechanism, symptoms, and intensive care management of massive abrin ingestion from rosary pea seeds.

Tags: toxicology, abrin-poisoning, critical-care, rosary-pea, medical-case-study, emergency-medicine, toxicology-teaching
## Abrin Poisoning: A Case of Deliberate Self-Poisoning
- **Patient Profile:** 28-year-old male presenting after massive ingestion of rosary pea seeds (Abrus precatorius).
- **Exposure:** ~150 crushed seeds mixed with water, plus 1kg of "gunja powder" obtained online.

## Mechanism & Clinical Toxicity
- **Mechanism:** Abrin is a ribosome-inactivating protein (RIP type II) that halts protein synthesis.
- **Lethality:** 1–2 seeds can be fatal in adults. 
- **Clinical Features:** Delayed onset (3–5 days), haemorrhagic gastroenteritis, acute kidney injury, and multiorgan failure.

## Investigations & Timeline
- **Initial Findings:** Severe hyponatremia (Na 114), metabolic acidosis (pH 7.23), and elevated creatinine (295 ̄̄mol/L).
- **Course:** Progression from initial GI distress to a 'quiescent phase' on Day 2, followed by rapid deterioration with bloody diarrhoea and shock on Day 3.

## Management & Teaching Points
- **Supportive Care:** Aggressive IV fluid resuscitation, N-acetylcysteine (NAC) as a free radical scavenger, and vasopressors.
- **Elimination:** Toxin is intracellular; therefore, dialysis and haemoperfusion are not effective for removal.
- **Key Takeaway:** Clinicians must anticipate a deceptive quiescent phase before rapid clinical decline. There is no specific antidote for abrin.
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