title: Bitter lupine beans ingestion in a child: a disregarded cause of acute anticholinergic toxicity.
abstract: We describe the case of a 6-year-old girl brought to the emergency department for the sudden onset of anticholinergic syndrome after the ingestion of a few home-made partially debittered lupine beans. She complained of blurry vision, headache, photophobia and nausea. No specific treatment was needed, and the symptoms resolved about 12 h after the exposure. Lupine beans are a popular and worldwide-diffused food. The bitter variety is rich in alkaloids harbouring anticholinergic activity and thus requires a debittering process before lupines can be eaten. Only four cases of acute toxicity, due to the ingestion of incompletely detoxified bitter lupines, have been reported in children so far; notwithstanding the small amount of lupines ingested, three of these cases were lethal.
  
  
  CONCLUSIONS
  Acute anticholinergic syndrome can arise after the consumption of a wide range of exogenous substances including partially debittered lupine beans. Paediatricians should be aware of bitter lupine toxicity, recognize possible cases of intoxication, ensure a prompt and appropriate supportive treatment and provide appropriate information about their danger.
authors.affiliation: Pediatric Residency Program, Department of Woman's and Child's Health, University of Padua, Via Giustiniani, 3, 35128, Padua, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Daverio
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Cavicchiolo
authors.forename: Paolo
authors.initials: P
authors.lastname: Grotto
authors.forename: Davide
authors.initials: D
authors.lastname: Lonati
authors.forename: Mara
authors.initials: M
authors.lastname: Cananzi
authors.forename: Liviana
authors.initials: L
authors.lastname: Da Dalt
mesh_terms: D000208:Acute Disease; D064807:Anticholinergic Syndrome / Q000175:diagnosis / Q000209:etiology*; D002648:Child; D004435:Eating; D005260:Female; D006801:Humans; D031297:Lupinus / Q000633:toxicity*