POISONOUS PARTS
Leaves.3
TOXICITY
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Toxic Constituents
Not identified.
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Toxic Dose
Toxicity was seen with excessive and prolonged consumption. The average amount of S. androgynous consumed in each poisoning case was 8.2 kg.4
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Mechanism
Exact mechanism is unknown. S. androgynus has been shown to cause bronchiolitis obliterans in an animal model. The aqueous extract was shown to be a potent activator of alveolar macrophages with production of tumor necrosis factor-α.5
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Poisoning Features
Dyspnoea, cough, bronchiolitis obliterans, palpitation, insomnia and oral ulcer.4
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Poisoning Events
In 1995, there was an outbreak of bronchiolitis obliterans in Taiwan associated with prolonged excessive consumption of uncooked S. androgynus juice for weight control. Subsequently, similar cases due to excessive and prolonged consumption of dried plant powder were also reported in Japan in 2005.4,6
CLINICAL MANAGEMENT
Supportive treatment. Patients with severe bronchiolitis obliterans may necessitate lung transplantation.7
IDENTIFICATION FEATURES
Shrubs, 1–3 m tall, glabrous throughout; branchlets slender, green. Leaf blades thinly papery or sub-membranous, 3–10 × 1.5–3.5 cm. Flowers in axillary clusters. Male flower calyx 5–12 mm in diameter. Female flower calyx lobes red, 5–6 × 3–5.5 mm. Capsules 1.2 × 1.7 cm, globose or depressed-globose, persistent calyx red. Seeds about 7 × 5 mm, triquetrous, black.8
LABORATORY ANALYSIS
Papaverine, a marker of S. androgynus, can be detected by HPLC-DAD, GC-MS and LC-MS/MS.9–11
