II. Pathophysiology
- Background
- Derived from seeds of the castor plant (Ricinus communis)
- Although originally native to Africa, castor plant now grows worldwide
- Ricin is a phytotoxin, Protein toxin used historically as Biological Weapon
- Used in assassination of Bulgarian exile Georgi Markov
- Gun disguised as Umbrella London 1978
- Implanted ricin pellet in his body
- Used in assassination of Bulgarian exile Georgi Markov
- Derived from seeds of the castor plant (Ricinus communis)
-
Pharmacokinetics
- Heat resistant (<80 C, <176 F)
- Water soluble
- Tasteless
- Not removed with Hemodialysis
- Toxicity
- Highly cytotoxic
- Ricin B Chain binds specific complex Carbohydrates on cell surface
- Ricin complex is transported intracelleularly where it is taken up by the endoplasmic reticulum
- Ricin A chain activates and disrupts ribosomes, stopping Protein synthesis and resulting in cell death
- Exposures
- Ingestion
- Ingestion is most common source of Ricin Poisoning (other exposures are more difficult)
- Single ingested seeds are typically nontoxic unless chewed or crushed
- Small particle aerosol inhalation
- No secondary aerosol risk to healthcare workers
- Injection
- Ingestion
III. Symptoms
- Early after Ingestion (first 6 hours): Gastrointestinal Symptoms
- Delayed ingestion effects (2 to 5 days after ingestion)
- Hepatotoxicity
- Nephrotoxicity
- Other systemic effects
- After Inhalation (18-24 hours): Respiratory effects
- Other Findings
- Weakness
- Fever
- Arthralgia
IV. Signs
- Pulmonary Edema
- Hypotension
- Vascular collapse
- Shock
- Disseminated Intravascular Coagulation (DIC)
- Multiple organ failure
V. Imaging: Inhalation
-
Chest XRay
- Bilateral infiltrates on Chest Radiographs
- Pulmonary Edema
VI. Labs
- See Unknown Ingestion
- Complete Blood Count
- Comprehensive metabolic panel
VII. Differential Diagnosis
VIII. Course
- Pathologic changes seen as early as 8 hours after exposure
IX. Management
- See Unknown Ingestion
- Skin Decontamination
-
Gastric Decontamination for ingestion
- Activated Charcoal if <1 hour after ingestion
- Consider Whole Bowel Irrigation (Polyethylene Glycol) for large ingestion
- Supportive care
- Intravenous Fluids
- Norepinephrine for refractory Hypotension
- Treat Pulmonary Edema
- Disposition
- May discharge if asymptomatic at 6 hours after exposure (esp. ingestion)
X. Prevention
- No Vaccine or antitoxin available
XI. References
- Tomaszewski (2024) Crit Dec Emerg Med 38(6): 38
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Related Studies
| Definition (NCI) | A highly toxic protein phytotoxin lectin and hemagglutin from the seeds of Ricinus communis, the castor oil plant. It agglutinates cells, is proteolytic, and causes lethal inflammation and hemorrhage if taken internally. It has N-glycosidase activity that cleaves 28S rRNA, halting protein synthesis; extreme cytotoxicity makes ricin an attractive candidate for artificial fusion with binding proteins to create cell-type-specific toxins. |
| Definition (MSH) | A protein phytotoxin from the seeds of Ricinus communis, the castor oil plant. It agglutinates cells, is proteolytic, and causes lethal inflammation and hemorrhage if taken internally. |
| Definition (CSP) | proteinaceous phytotoxin from the castor oil plant, Ricinus communis; A chain has glycosidase activity which cleaves 28S rRNA, halting protein synthesis; extreme cytotoxicity makes ricin an attractive candidate for artificial fusion with binding proteins to create cell-type-specific toxins. |
| Concepts | Hazardous or Poisonous Substance (T131) , Amino Acid, Peptide, or Protein (T116) |
| MSH | D012276 |
| SnomedCT | 30096004 |
| LNC | LP33246-7, LP35837-1, MTHU016499, MTHU018738 |
| English | Castor Bean Lectin, Lectin, Castor Bean, Lectin, Ricinus, Ricinus Lectin, Ricinus Toxin, Toxin, Ricinus, Ricins, RCA 60, RCA60, Ricin [Chemical/Ingredient], ricin, Ricin, Ricin toxin, RICIN, Ricin (substance), Ricinus Communis Agglutinin II |
| Swedish | Ricin |
| Czech | ricin |
| Finnish | Risiini |
| Italian | Ricino tossina, RCA 60, Lectina del seme di ricino, RCA60, Ricina, Lectina del ricinus, Lectina della ricina |
| Russian | LEKTIN, RICINUS, RITSIN, KLESHCHEVINY OBYKNOVENNOI LEKTIN, LEKTIN KLESHCHEVINY, LEKTIN KLESHCHEVINY OBYKNOVENNOI, КЛЕЩЕВИНЫ ОБЫКНОВЕННОЙ ЛЕКТИН, ЛЕКТИН, RICINUS, ЛЕКТИН КЛЕЩЕВИНЫ, ЛЕКТИН КЛЕЩЕВИНЫ ОБЫКНОВЕННОЙ, РИЦИН |
| Japanese | トウゴマレクチン, ひましレクチン, リシン(Ricin), ヒマシレクチン, レクチン-トウゴマ, レクチン-ヒマシ |
| Polish | Rycyna |
| Spanish | Lectina de Ricinus communis, ricino (sustancia), ricino, Lectina de Ricino, Lectina de Semilla de Higuera Infernal, Lectina de Semilla de Ricino, Ricina |
| Portuguese | Lectina de Ricinus communis, Lectina da Semente da Mamona, Lectina da Semente do Rícino, Lectina do Rícino, Ricina |
| French | Ricine |
| German | Kastorlektin, Lektin, Kastor-, Lektin, Rizinus-, Ricin |
Ontology: Ricin poisoning (C1443942)
| Concepts | Injury or Poisoning (T037) |
| SnomedCT | 27936006, 409617000 |
| English | Ricin poisoning, Poisoning by ricin, Ricin poisoning (disorder) |
| Spanish | intoxicación por ricino, intoxicación por ricina (trastorno), intoxicación por ricina |
