Epidemic dropsy in India

Epidemic dropsy is a clinical state resulting from use of edible oils adulterated with Argemone mexicana oil. Sanguinarine and dehydrosanguinarine are two major toxic alkaloids ofArgemone oil, which cause widespread capillary dilatation, proliferation and increased capillary permeability. Leakage of...

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Bibliographic Details
Published in:Postgraduate Medical Journal 1999-11, Vol.75 (889), p.657-661
Main Authors: Sharma, B D, Malhotra, Sanjay, Bhatia, Vikram, Rathee, Mandeep
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Alkaloids - poisoning
Argemone mexicana
Benzophenanthridines
Biological and medical sciences
Capillaries
Child
Child, Preschool
Edema - chemically induced
Edema - diagnosis
Edema - prevention & control
epidemic dropsy
Female
Food Contamination - prevention & control
Food toxicology
Humans
India
Infant
Isoquinolines
Male
Medical sciences
Middle Aged
Pigmentation Disorders - chemically induced
Pigmentation Disorders - prevention & control
Plants
Review
sanguinarine
Toxicology
Tropical medicine
Vasodilator Agents - poisoning
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Summary:Epidemic dropsy is a clinical state resulting from use of edible oils adulterated with Argemone mexicana oil. Sanguinarine and dehydrosanguinarine are two major toxic alkaloids ofArgemone oil, which cause widespread capillary dilatation, proliferation and increased capillary permeability. Leakage of the protein-rich plasma component into the extracellular compartment leads to the formation of oedema. The haemodynamic consequences of this vascular dilatation and permeability lead to a state of relative hypovolemia with a constant stimulus for fluid and salt conservation by the kidneys. Illness begins with gastroenteric symptoms followed by cutaneous erythema and pigmentation. Respiratory symptoms such as cough, shortness of breath and orthopnoea progressing to frank right-sided congestive cardiac failure are seen. Mild to moderate anaemia, hypoproteinaemia, mild to moderate renal azotemia, retinal haemorrhages, and glaucoma are common manifestations. There is no specific therapy. Removal of the adulterated oil and symptomatic treatment of congestive cardiac failure and respiratory symptoms, along with administration of antioxidants and multivitamins, remain the mainstay of treatment. Selective cultivation of yellow mustard, strict enforcement of the Indian Food Adulteration Act, and exemplary punishment to unscrupulous traders are the main preventive measures.
ISSN:0032-5473
1469-0756
DOI:10.1136/pgmj.75.889.657