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Medline ® Abstract for Reference 44

of 'Potentially toxic plant ingestions in children: Clinical manifestations and evaluation'

[Accidental poisoning with podophyllin: a case with study of peripheral nerve].
Chapon F, Dupuy B, Gosset S, Carjuzaa A, Berthelin C, Viader F, Lechevalier B
Rev Neurol (Paris). 1991;147(3):240.
A 53 year-old veterinary surgeon accidentally ingested 0.8 g of podophyllin. Twelve hours later, he was deeply comatose, with clinical and EMG signs of extensive axonal sensorimotor and autonomic peripheral neuropathy. In addition, transient bone marrow and hepatic toxicity occurred. The coma lasted 2 weeks. Systemic and neurological disturbances started to improve at 3 months post-onset, but the patient died four months later from gastro-intestinal bleeding. Sural nerve biopsy showed loss of myelinated fibers and signs of axonal degeneration with type E teased fibers. The cytoplasm of Schwann and endothelial cells was vacuolated and swelled. Diffuse interstitial aedema was noted. Podophyllin acts as a spindle poison, binds microtubular proteins and inhibits axoplasmic flow.
Service de Neurologie Dejerine et Laboratoire de Neuropathologie, CHU de Caen.