Management of Castor Bean Seed-Associated Intraventricular Hemorrhage with Fresh Frozen Plasma: A Case Report

Abstract

Introduction: Castor bean seed is used to control some medical conditions including diabetes mellitus due to popular belief in its effectiveness. However it may cause severe poisoning in humans and animals and its components (ricin) might be used as a biological weapon. In the present case, a rare intra-ventricular hemorrhage followed by unconsciousness had occurred after poisoning with caster bean. Because there is no direct antidote or reversal agent for this condition, fresh frozen plasma (FFP) was prescribed to control the hemorrhage and good results were achieved. Case Presentation: A 63-year-old female taking castor bean seed as a treatment for her diabetes was admitted to the emergency ward for a comatose state. A computed tomography image of her head demonstrated an intraventricular hemorrhage. Symptomatic and supporting care was prescribed. After two weeks without significant improvement, the patient was administered five units of FFP. However, the patient's neurological status dramatically improved and remained stable. Conclusions: Intraventricular hemorrhage followed by comatose state is a rare finding of the castor bean seed ingestion. The patient's condition improved dramatically after FFP transfusion.