Case Report

Volume: 8 | Issue: 7 | Published: Aug 21, 2024 | Pages: 154 - 157 | DOI: 10.24911/ejmcr.173-1718496977

Anticholinergic toxidrome: a rare consequence of lupin ingestion - a case report and literature review


Authors: Mohammed A. Alharbi orcid logo , Fatima Hatem Al Saeed , Dunya Alfaraj


Article Info

Authors

Mohammed A. Alharbi

Medical Intern, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia

orcid logo ORCID

Fatima Hatem Al Saeed

Emergency Medicine Resident, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia

Dunya Alfaraj

Department of Emergency Medicine, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.

Publication History

Received: June 16, 2024

Accepted:

Published: August 21, 2024


Abstract


Background: Lupin beans, a yellow legume seed from the Lupinus plant, are commonly used in Southern Europe, Latin America, and the Middle East. Despite their bitter taste, lupin beans are highly nutritious and rich in protein, making them popular snacks. The bitter taste is due to the presence of over 150 quinolizidine alkaloids, with Lupanine being the predominant alkaloid. If not properly debittered before ingestion, lupin toxicity and anticholinergic symptoms can occur. Case Presentation: A 49-year-old healthy Egyptian man presented with symptoms such as dry mouth, unsteadiness, constipation, and urinary retention for 6 hours. After investigation, it was discovered that he had consumed 400 g of bitter lupin beans within a 1-hour period, around 4-6 hours before the symptom onset. The patient was oriented, conscious, and alert, showing no signs of pain or distress. His vital signs were normal, and he had normal cardiovascular, pulmonary, gastrointestinal, and neurological examinations. His eye examination revealed fixed, dilated pupils bilaterally, blurry vision, and normal eye movement bilaterally. Laboratory tests were normal. The patient received Ringer's lactate intravenously and was closely monitored in the emergency department. Over a 3-hour period, all symptoms and signs resolved with fluid management alone, and the patient was discharged home following his improvement. Conclusion: This report highlights the importance of history taking in diagnosing food-related diseases and emphasizes that physicians should consider lupin toxicity as a differential diagnosis in cases presenting with anticholinergic symptoms.

Keywords: Anticholinergic syndrome, cholinergic antagonists, lupinus, quinolizidine alkaloids, toxicity, green


Pubmed Style

Mohammed A. Alharbi, Fatima Hatem Al Saeed, Dunya Alfaraj. Anticholinergic toxidrome: a rare consequence of lupin ingestion - a case report and literature review. EJMCR. 2024; 21 (August 2024): 154-157. doi:10.24911/ejmcr.173-1718496977

Web Style

Mohammed A. Alharbi, Fatima Hatem Al Saeed, Dunya Alfaraj. Anticholinergic toxidrome: a rare consequence of lupin ingestion - a case report and literature review. https://ejmcr.com/articles/1214 [Access: December 25, 2024]. doi:10.24911/ejmcr.173-1718496977

AMA (American Medical Association) Style

Mohammed A. Alharbi, Fatima Hatem Al Saeed, Dunya Alfaraj. Anticholinergic toxidrome: a rare consequence of lupin ingestion - a case report and literature review. EJMCR. 2024; 21 (August 2024): 154-157. doi:10.24911/ejmcr.173-1718496977

Vancouver/ICMJE Style

Mohammed A. Alharbi, Fatima Hatem Al Saeed, Dunya Alfaraj. Anticholinergic toxidrome: a rare consequence of lupin ingestion - a case report and literature review. EJMCR. (2024), [cited December 25, 2024]; 21 (August 2024): 154-157. doi:10.24911/ejmcr.173-1718496977

Harvard Style

Mohammed A. Alharbi, Fatima Hatem Al Saeed, Dunya Alfaraj (2024) Anticholinergic toxidrome: a rare consequence of lupin ingestion - a case report and literature review. EJMCR, 21 (August 2024): 154-157. doi:10.24911/ejmcr.173-1718496977

Chicago Style

Mohammed A. Alharbi, Fatima Hatem Al Saeed, Dunya Alfaraj. "Anticholinergic toxidrome: a rare consequence of lupin ingestion - a case report and literature review." 21 (2024), 154-157. doi:10.24911/ejmcr.173-1718496977

MLA (The Modern Language Association) Style

Mohammed A. Alharbi, Fatima Hatem Al Saeed, Dunya Alfaraj. "Anticholinergic toxidrome: a rare consequence of lupin ingestion - a case report and literature review." 21.August 2024 (2024), 154-157. Print. doi:10.24911/ejmcr.173-1718496977

APA (American Psychological Association) Style

Mohammed A. Alharbi, Fatima Hatem Al Saeed, Dunya Alfaraj (2024) Anticholinergic toxidrome: a rare consequence of lupin ingestion - a case report and literature review. , 21 (August 2024), 154-157. doi:10.24911/ejmcr.173-1718496977