title: Epidemic dropsy--a clinical study of the Delhi outbreak.
abstract: BACKGROUND
  A major outbreak of epidemic dropsy occurred in Delhi, India, in August-September 1998, due to the consumption of contaminated mustard oil.
  
  
  METHODS
  The clinical data of 212 adult patients of epidemic dropsy who presented to our hospital is analysed.
  
  
  RESULTS
  Pitting pedal oedema (100%), skin erythema (75%), limb tenderness (63%), diarrhea (51%) and hepatomegaly (34%) were the prominent clinical manifestations observed in the patients. Superficial retinal haemorrhages and retinal venous dilatation was observed on fundus examination and 9% of patients developed an open angle glaucoma over a three month follow up period. Cardiac failure was present in 14% of patients. Most patients had mild disease which responded to cessation of mustard oil consumption, bed rest, diuretics and antioxidants. There were six deaths, all of whom had intractable cardiac failure. A unique feature of this outbreak was the documentation of acute renal failure in three patients, a phenomenon never described previously.
  
  
  CONCLUSIONS
  Strict law enforcement to prevent the contamination of edible oils is essential to avoid the occurrence of future similar outbreaks.
authors.affiliation: Department of Medicine, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi-110002, India.
authors.forename: N P
authors.initials: NP
authors.lastname: Singh
authors.forename: S
authors.initials: S
authors.lastname: Anuradha
authors.forename: D K
authors.initials: DK
authors.lastname: Dhanwal
authors.forename: K
authors.initials: K
authors.lastname: Singh
authors.forename: A
authors.initials: A
authors.lastname: Prakash
authors.forename: K
authors.initials: K
authors.lastname: Madan
authors.forename: S K
authors.initials: SK
authors.lastname: Agarwal
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D004196:Disease Outbreaks; D004487:Edema / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D005506:Food Contamination / Q000517:prevention & control*; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009149:Mustard Plant; D010936:Plant Extracts / Q000009:adverse effects*; D010938:Plant Oils
chemical_list: D010936:Plant Extracts; D010938:Plant Oils; C027793:mustard oil