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Postgrad Med J 75:657-661 doi:10.1136/pgmj.75.889.657
  • Review
  • Classic diseases revisited

Epidemic dropsy in India

  1. B D Sharma,
  2. Sanjay Malhotra,
  3. Vikram Bhatia,
  4. Mandeep Rathee
  1. Department of Medicine, Safdarjang Hospital, New Delhi 110029, India
  1. Dr BD Sharma, C-166 Saraswati Kunj, Mother Dairy Road, IP Extension, Delhi 110092, India
  • Accepted 7 June 1999

Abstract

Epidemic dropsy is a clinical state resulting from use of edible oils adulterated with Argemone mexicana oil. Sanguinarine and dehydrosanguinarine are two major toxic alkaloids ofArgemone oil, which cause widespread capillary dilatation, proliferation and increased capillary permeability. Leakage of the protein-rich plasma component into the extracellular compartment leads to the formation of oedema. The haemodynamic consequences of this vascular dilatation and permeability lead to a state of relative hypovolemia with a constant stimulus for fluid and salt conservation by the kidneys. Illness begins with gastroenteric symptoms followed by cutaneous erythema and pigmentation. Respiratory symptoms such as cough, shortness of breath and orthopnoea progressing to frank right-sided congestive cardiac failure are seen. Mild to moderate anaemia, hypoproteinaemia, mild to moderate renal azotemia, retinal haemorrhages, and glaucoma are common manifestations. There is no specific therapy. Removal of the adulterated oil and symptomatic treatment of congestive cardiac failure and respiratory symptoms, along with administration of antioxidants and multivitamins, remain the mainstay of treatment. Selective cultivation of yellow mustard, strict enforcement of the Indian Food Adulteration Act, and exemplary punishment to unscrupulous traders are the main preventive measures.

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