Premium
Early plasma exchange for treating ricin toxicity in children after castor bean ingestion
Author(s) -
Wang Chengfeng,
Nie Xiaojing,
Chen Guangming,
Yu Zihua,
Li Zheng,
Sun Zhiwen,
Weng Zengfeng,
Yang Yuying,
Chen Shulian,
Zheng Sirui,
Luo Yingyun,
Lu Yanting,
Cao Huiqin,
Zhan Haixia
Publication year - 2015
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/jca.21351
Subject(s) - ricin , medicine , ingestion , toxicity , pharmacology , intensive care medicine , immunology , biochemistry , toxin , chemistry
Plasma exchange (PE) for the treatment of ricin toxicity has not been previously reported. Here we describe the use of PE to treat children who experienced ricin toxicity after ingesting castor beans. Seven children (median age: 8.1 years) who consumed castor beans (median: 5 beans) were treated with PE. All had bradycardia and sinus arrhythmia, and most had experienced episodes of vomiting and/or diarrhea. PE settings were blood flow, 50–80 mL/min; PE rate, 600–800 mL/h; volume of exchange, 1440–1950 mL. Median time from ingestion to PE was 73 h. All clinical symptoms disappeared and vital signs rapidly returned to normal after PE; no severe organ dysfunction occurred. All children were discharged and recovered uneventfully. Concentrations of all serum biochemical parameters significantly decreased immediately after PE. Some, but not all, of these parameters were also significantly decreased at 48 and 72 h after PE compared with before PE. Our findings suggest that PE can be an effective early intervention in the treatment of ricin toxicity due to castor bean ingestion. J. Clin. Apheresis 30:141–146, 2015. © 2014 Wiley Periodicals, Inc.