Ricin is a potent toxalbumin that inhibits protein synthesis and causes severe cytotoxic effects on multiple organ systems. It may be one of the most poisonous naturally occurring substances known.45 Although present in all parts of the plant, it is concentrated most in the seeds. Beans are covered by a hard, relatively impervious outer shell that must be chewed or in some way broken in order for the ricin to result in toxicity.
Symptoms include delayed gastroenteritis, which may be severe and hemorrhagic, followed by delirium, seizures, coma, and death. Beans are particularly antigenic and may cause severe hypersensitivity and cutaneous and systemic allergic reactions.
Whole bowel irrigation (WBI) has been advocated to ensure rapid and complete decontamination of the GI tract. Rapid elimination of the bean before erosion of the outer shell occurs may decrease or prevent the release of potent toxins. Beans should be counted to assure complete recovery. Patients should be observed for at least 8 to 12 h. Once symptomatic, supportive care involves attention to fluid, glucose, and electrolyte replacement.
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