Pancytopenia in epidemic dropsy: a case report

Abstract

Epidemic dropsy is caused by consumption of mustard oil contaminated with argemone oil, characterized by pitting edema of the extremities, especially lower limbs; cutaneous erythema and local tenderness; Glaucoma and other visual field defects, leading to blindness; cardiac and respiratory problems leading to death are among the most severe manifestations. A family consuming self cultivated contaminated mustard oil suffered from dysnea and pedal edema; 5 of them approached tertiary center after the demise of two members an elderly and a kid at home. Out of those five, 3 were hospitalized in medicine department while 2 were admitted in paediatric department. So here we report a case series of 3 patients residents of Prayagraj Uttar Pradesh, India, who presented in March 2023 with all the classical features of ED all belonging to the same family admitted in medicine department. They had variable presentations but surprisingly all of them had pancytopenia, all had AKI, all had reticular  hyperpigmented rash, all landed up in non cardiogenic edema but the one with underlying Perimembraneous VSD  had increased severity, two had renal concretions, one had visual defect and the one using it topically too, had diffuse hyperpigmented skin and hair loss as well. The adulteration of oil with argemone was confirmed by nitric acid test and ferric chloride test. Patients felt improvement on conservative management. AKI improved in 45 days on an average. This is the first case report having pancytopenia in all cases never found in any single family outbreak or multiple family outbreak of epidemic dropsy.

Keywords: Epidemic Dropsy, Mustard oil, Argemone maxicana, AKI, Pancytopenia

Received on, 12 February 2025

Accepted on, 17 March 2025

Published on, 28 April 2025