Abrin's mechanism of toxicity is interference of protein synthesis through ribosome inhibition. Symptoms depend on the route of exposure and may begin within hours of ingestion or may be delayed up to 3 days.
With inhalation, patients will develop respiratory distress, fever, cough and rhinorrhea, and chest tightness often with diaphoresis. Chest x-ray will reveal diffuse bilateral infiltrates consistent with pulmonary edema. Ingestion will result in vomiting and bloody diarrhea, abdominal pain, weakness, and disorientation. Neurologic symptoms can progress to seizures and/or coma.
Supportive care includes maintaining adequate hydration and replacing depleted electrolytes. Bowel irrigation and attempts to recover any jequirity beans may be considered in select circumstances.
T50.994A – Poisoning by other drugs, medicaments and biological substances, undetermined, initial encounter
275385007 – Biological substance poisoning
Differential Diagnosis & Pitfalls