Oral Mucosal Irritating Plant Ingestion in Hong Kong: Epidemiology and Its Clinical Presentation

Abstract

To study the local epidemiology and clinical presentation after ingestion of oral mucosal irritating plants. Methodology: Cases presenting with immediate oral mucosal irritation after plant product ingestion from July 2005 to June 2009 were retrieved from the Hong Kong Poison Information Centre's clinical database. Their clinical features and management were reviewed. Results: Thirty cases were retrieved and analysed, including 14 males and 16 females. Poisoning occurred all year round with no seasonal predilection. Vomiting and dysphagia were the two most common symptoms other than immediate oral mucosal irritation. Half of the cases could be managed with symptomatic treatment and discharged after a few hours of observation. Six patients presented with angioedema and were managed initially with the use of intravenous steroid, antihistamine and with or without adrenaline. Urgent airway assessment with laryngoscope was performed in 3 patients. No patient required endotracheal intubation. Conclusion: Oral mucosal irritating plant ingestion is not uncommon in Hong Kong. Its clinical feature can mimic angioedema on presentation. Immediate and localized oral mucosal symptoms after plant product ingestion are the key to diagnosis.

Poisoning by toxic plants in Hong Kong: a 15-year review

“…Some of the cases have been previously published as case reports by the authors and other units. [12][13][14][15][16][17][18][19] Funding/support This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.…”

“…4 Consumption of wild plants as "medicinal herbs" or food is not an uncommon practice in Hong Kong, and severe plant poisoning cases have been reported. [11][12][13][14][15][16][17][18][19] However, local epidemiology data on plant poisoning are ORIGINAL ARTICLE patients (n=61, 98%) used the plants intentionally: as a medicinal herb (n=31), as food (n=29), and for attempting suicide (n=1). Reasons for using the poisonous plants included misidentification (n=34, 55%), unawareness of the toxicity (n=20, 32%), and contamination (n=6, 10%).…”

Two cases of poisoning by raw taro leaf and how a poison control centre, food safety inspectors, and a specialty supermarket chain found a solution

“…It is largely thought to stem from specialized plant cells called idioblasts, which contain bundles of oxalate crystals called raphides coated with a proteolytic enzyme. When the plant is crushed or chewed, the idioblasts forcibly eject the raphides along with the proteolytic enzyme into the oropharynx causing micro-trauma and a local reaction (Bradbury and Nixon 1998;Noonan and Savage 1999;Tagwireyi and Ball 2001;Paull et al 1999;Savage et al 2009;Pang et al 2010).…”