title: Case report of a small outbreak of epidemic dropsy.
abstract: Epidemic dropsy results from use of edible oils adulterated with Argemone mexicans oil. We report of the disease in a family caused due to sesame oil adulteration. Peculiarity to report this disease is that it occurred due to consumption of contaminated sesame seeds oil instead of mustard oiland secondly epidemic dropsy is also not very common in western Rajasthan. Five members of a family presented to the hospital with history of generalised body swelling, itching and marked cutaneous flush. Few of them also have shortness of breath, dry cough, palpitation, diarrhoea, vomiting and haemoptysis. On physical examination rashes, pallor and signs of cardiac failure were present in few patients. None of them had neurological symptoms and signs. After multiple interviews history of consumption of home made sesame seeds oil was explored in the family and the differential diagnosis of epidemic dropsy was made. Edible oil sample of the sesame seeds oil turned out to be positive for sanguinarine. Sanguinarine and dehydrosanguinarine are two major toxic alkaloids of Argemone 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. There is no specific therapy. Removal of the adulterated oil and symptomatic treatment of congestive cardiac failure and respiratory symptoms, along with administration of anti-oxidants and multivitamins, remains the mainstay of treatment.
authors.affiliation: Department of Medicine, MDM Hospital, Dr SN Medical College, Jodhpur 342003.
authors.forename: Girdhari Lal
authors.initials: GL
authors.lastname: Dhayal
authors.affiliation: Department of Medicine, MDM Hospital, Dr SN Medical College, Jodhpur 342003.
authors.forename: Harish
authors.initials: H
authors.lastname: Agarwal
authors.affiliation: Department of Medicine, MDM Hospital, Dr SN Medical College, Jodhpur 342003.
authors.forename: Arvind
authors.initials: A
authors.lastname: Mathur
authors.affiliation: Department of Medicine, MDM Hospital, Dr SN Medical College, Jodhpur 342003.
authors.forename: Shuchi
authors.initials: S
authors.lastname: Mathur
authors.affiliation: Department of Medicine, MDM Hospital, Dr SN Medical College, Jodhpur 342003.
authors.forename: Naveen
authors.initials: N
authors.lastname: Kishoria
authors.affiliation: Department of Medicine, MDM Hospital, Dr SN Medical College, Jodhpur 342003.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Jain
authors.affiliation: Department of Medicine, MDM Hospital, Dr SN Medical College, Jodhpur 342003.
authors.forename: Rahul
authors.initials: R
authors.lastname: Choudhary
authors.affiliation: Department of Medicine, MDM Hospital, Dr SN Medical College, Jodhpur 342003.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Sharma
authors.affiliation: Department of Medicine, MDM Hospital, Dr SN Medical College, Jodhpur 342003.
authors.forename: Suresh
authors.initials: S
authors.lastname: Bishnoi
authors.affiliation: Department of Medicine, MDM Hospital, Dr SN Medical College, Jodhpur 342003.
authors.forename: Shyam
authors.initials: S
authors.lastname: Mathur
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004196:Disease Outbreaks; D004487:Edema / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010938:Plant Oils / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D010938:Plant Oils; C030610:argemone oil