title: N-acetylcysteine in Cleistanthus collinus Poisoning: A Report of Two Cases in Children.
abstract: Cleistanthus collinus, also known as Oduvanthalai in Tamil, is the most commonly encountered plant poison in southern India. The leaves are used for poisoning humans (suicide or homicide) and animals (cattle and fish) and as an abortifacient, especially in rural south India. Although this poisoning is commonly reported in adults, data regarding the use of N-acetylcysteine in pediatric poisoning is lacking. We report two previously healthy male siblings of pediatric age group who ingested the liquid extracted from crushed leaves of this plant given to them by their mother as a means of deliberate harm. Both patients developed distal renal tubular acidosis, with hypokalemia. The younger sibling also developed myocardial toxicity. Other significant findings noted include hypocalcemia, hypomagnesemia and elevated liver enzymes. Both patients received supportive care along with N-acetylcysteine infusion, and showed complete recovery within 10 days.
authors.affiliation: Department of Pediatrics, JIPMER, Puducherry, India - 605 006 krramesh_iway@yahoo.co.in rameshkumar.r@jipmer.edu.in.
authors.forename: Shreya
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Department of Pediatrics, JIPMER, Puducherry, India - 605 006.
authors.forename: Ramachandran
authors.initials: R
authors.lastname: Rameshkumar
authors.affiliation: Department of Pediatrics, JIPMER, Puducherry, India - 605 006.
authors.forename: Subramanian
authors.initials: S
authors.lastname: Mahadevan
mesh_terms: D000111:Acetylcysteine / Q000008:administration & dosage*; D058186:Acute Kidney Injury / Q000139:chemically induced*; D002648:Child; D006027:Glycosides / Q000506:poisoning*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007008:Hypokalemia / Q000139:chemically induced; D007684:Kidney Tubules / Q000503:physiopathology*; D008297:Male; D010936:Plant Extracts / Q000506:poisoning*; D010939:Plant Poisoning / Q000503:physiopathology*; D013406:Suicide, Attempted; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced
chemical_list: D006027:Glycosides; D010936:Plant Extracts; D000111:Acetylcysteine
keywords: Cleistanthus collinus; N-acetylcysteine; acute kidney injury; children; poisoning