Euphorbia tirucalli 綠玉樹

POISONOUS PARTS

Latex.⁴

TOXICITY

• Toxic Constituents

  4-Deoxyphorbol esters.^5,6

• Mechanism

  4-Deoxyphorbol esters are strong irritants to skin, eyes and mucosal surface. The plant extract may facilitate EBV infection, and is hence considered a risk factor for EBV-associated cancers such as Hodgkin lymphoma, Burkitt lymphoma and nasopharyngeal carcinoma.^5–12

• Poisoning Features

  Skin contact: irritant contact dermatitis. Eye contact: keratoconjunctivitis, blindness in severe cases. Ingestion: gastrointestinal bleeding.^4,13–16

• Poisoning Events

  Multiple cases of keratoconjunctivitis and uveitis after accidental ocular exposure to the latex of E. tirucalli, usually while trimming the tree, have been reported worldwide. Most patients recovered uneventfully, but blindness could occur. Besides, the plant is considered as a possible cofactor of the endemic Burkitt lymphoma in the Lymphoma Belt of Africa, where its incident rate is unusually high in children.^11–17

CLINICAL MANAGEMENT

Supportive treatment. For skin and ocular exposure, affected area could be irrigated with water.^4,13–16

IDENTIFICATION FEATURES

Shrubs or small trees, 1–3(–6) m tall, with milky juice. Branches unarmed, cylindrical, very divergent, about 6 mm in diameter, succulent, bright green. Leaves none or very few, 7–15 × 0.7–1.5 mm, caducous. Cyathia clustered on a very short stalk in the forks of some of the smaller branches. Capsules about 8 × 8 mm, rhomboid-triangular, smooth.¹⁸

MEDICINAL USES

Whole plant used in TCM: promote lactation, kill parasites, remove toxin. Recommended dose: 6–9 g.²

LABORATORY ANALYSIS

Deoxyphorbol esters can be detected by LC-MS/MS.¹⁹