Emergency Medicine Book

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Ricin

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  1. Historical
    1. Used in assassination of Bulgarian exile Georgi Markov
      1. Gun disguised as Umbrella London 1978
      2. Implanted ricin pellet in his body
  2. Pathophysiology
    1. Mechanism
      1. Ricin is a protein toxin used as Biological Weapon
      2. Derived from castor plant (Ricinus communis)
      3. Small particle aerosol
    2. Transmission
      1. No secondary aerosol risk to healthcare workers
  3. Symptoms
    1. Weakness
    2. Fever
    3. Cough
    4. Dyspnea
    5. Chest tightness
    6. Arthralgia
    7. Gastrointestinal symptoms if ingested
  4. Signs
    1. Pulmonary edema
    2. Hypotension
    3. Vascular collapse
    4. Shock
    5. Disseminated Intravascular Coagulation (DIC)
    6. Multiple organ failure
  5. Radiology: Chest XRay
    1. Bilateral infiltrates on chest radiographs
    2. Pulmonary edema
  6. Labs
    1. Complete Blood Count
      1. Neutrophilic Leukocytosis
  7. Differential Diagnosis
    1. Staphylococcal Enterotoxin B (SEB)
    2. Q Fever
    3. Tularemia
    4. Plague
    5. Phosgene (Chemical Toxin)
  8. Course
    1. Pathologic changes seen as early as 8 hours
    2. Symptom onset 18-24 hours after inhalation
    3. Severe respiratory distress and failure in 36-72 hours
  9. Management
    1. Supportive for pulmonary edema
    2. Gastric Decontamination for ingestion
  10. Prevention
    1. No vaccine or antitoxin available

Ricin (C0035569)

Definition (MSH)A protein phytotoxin from the seeds of Ricinus communis, the castor oil plant. It agglutinates cells, is proteolytic, and causes lethal inflammation and hemorrhage if taken internally.
Definition (CSP)proteinaceous phytotoxin from the castor oil plant, Ricinus communis; A chain has glycosidase activity which cleaves 28S rRNA, halting protein synthesis; extreme cytotoxicity makes ricin an attractive candidate for artificial fusion with binding proteins to create cell-type-specific toxins.
Definition (NCI)A highly toxic protein phytotoxin lectin and hemagglutin from the seeds of Ricinus communis, the castor oil plant. It agglutinates cells, is proteolytic, and causes lethal inflammation and hemorrhage if taken internally. It has N-glycosidase activity that cleaves 28S rRNA, halting protein synthesis; extreme cytotoxicity makes ricin an attractive candidate for artificial fusion with binding proteins to create cell-type-specific toxins.
ConceptsAmino Acid, Peptide, or Protein (T116) , Hazardous or Poisonous Substance (T131)
MSHD012276
EnglishCastor Bean Lectin, RCA 60, RCA60, Ricin, Ricin toxin, Ricins, Ricinus Communis Agglutinin II, Ricinus Lectin, Ricinus Toxin
Spanishricino
Parent ConceptsPhytotoxin (C0032086), Albumins (C0001924), Plant Lectins (C0304052), Ribosome Inactivating Proteins, Type 2 (C1956054), Protein Synthesis Inhibitors (C0033671), Nutritional Toxin (C1518515), Lectin (C0023206)
SourcesCSP, LCH, LNC, MSH, NCI, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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