Summary
A 22-year-old man developed a severe sensorimotor neuropathy following ingestion of podophyllin, which had been prescribed for genital condylomata. The initial toxic symptoms were vomiting and diarrhoea, followed by peripheral neuropathy. The neuropathy was still present 18 months later. Nerve conduction studies and sural nerve biopsy confirmed the presence of axonal degeneration.
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References
Balucani M, Zellers DD (1964) Podophyllum resin poisoning with complete recovery. JAMA 189:639–640
Campbell AN (1980) Accidental poisoning with podophyllin. Lancet 1:206–207
Casey EB, Jellife AM, Le Quesne PM, Millet YL (1973) Vincristine neuropathy: clinical and electrophysiological observations. Brain 96:69–86
Cassidy DE, Drewry J, Fanning JP (1982) Podophyllum toxicity: a report of a fatal case and review of the literature. J Toxicol Clin Toxicol 19:35–44
Chamberlain MJ, Reynolds AL, Yeoman WB (1972) Toxic effect of podophyllum application in pregnancy. Br Med J 3:391–392
Clark ANG, Parsonage MJ (1957) A case of podophyllin poisoning with involvement of the nervous system. Br Med J 2:1155–1157
Dodd DG, Edis RH (1984) Coma and neuropathy after ingestion of herbal laxative containing podophyllin. Med J Aust 140:495–496
Dudley WH (1890) Fatal podophyllin poisoning. Med Rec 37:409
Filley CM, Graff-Rudford NR, Lacy JR, Heitner MA, Earnest MP (1982) Neurologic manifestations of podophyllin toxicity. Neurology 32:308–311
Griffin JW, Watson DF (1988) Axonal transport in neurological disease. Ann Neurol 23:3–13
Hancock BW, Naysmith A (1975) Vincristine-induced autonomic neuropathy. Br Med J 3:207
Hasler JF, Standish SM (1969) Podophyllin treatment of hairy tongue: a warning. J Am Dent Assoc 78:563–567
Jacobs JM (1980) Vascular permeability and neural injury. In: Spencer PS, Schaumberg HH (eds) Experimental and clinical neurotoxicology. Williams and Wilkins, Baltimore, pp 102–117
Jacobs JM, Love S (1985) Qualitative and quantitative morphology of human sural nerve at different ages. Brain 108:897–924
Kaplan IW (1942) Condylomata acuminata. New Orleans Med Surg J 94:388–390
Kelleher JK (1978) Correlation of tubulin-binding and antitumor activities of podophyllotoxin analogs. Cancer Treat Rep 62:1443–1447
Leslie KO, Shitamoto B (1982) The bone marrow in systemic Podophyllin toxicity. Am J Clin Pathol 77:478–480
Moher LM, Maurer SA (1979) Podophyllum toxicity: case report and literature review. J Fam Pract 9:237–240
Montaldi H, Giambrone JP, Courey NG, Taeti P (1974) Podophyllin poisoning associated with the treatment of condyloma acuminatum: a case report. Am J Gynecol 119:1130–1131
Paulson JC, McClure WO (1975) Inhibition of axoplasmic transport by colchicine, vinblastine and podophyllotoxin: an effect on microtubules. Ann NY Acad Sci 253:517–527
Prentiss DW (1882) Effect of an overdose of Podophyllin — amount taken about centigrams (ten grains). Philadelphia Medical Times 12:520
Schirren CF (1966) Schwere Allgemeinvergiftung nach örtlicher Anwendung von Podophyllinspiritus bei spitzen Condylomen. Hautarzt 17:321–322
Slater GE, Rumack BH, Petreson RG (1978) Podophyllin poisoning: systemic toxicity following cutaneous application. Obstet Gynecol 52:94–96
Spencer PS, Schaumberg HH (1976) Central and peripheral distal axonopathy — the pathology of dying-back polyneuropathies. In: Zimmerman HM (ed) Progress in neuropathology, vol 3. Grune and Stratton, New York, pp 253–295
Stoehr GP, Peterson AL, Taylor WJ (1978) Systemic complications of local podophyllin therapy. Ann Intern Med 89:362–363
Tosenstein G, Tosenstein H, Freeman M, Seston N (1976) Podophyllin, a dangerous laxative. Paediatrics 57:419
Ward JW, Clifford WS, Monaco AR, Bickerstaff HS (1954) Fatal systemic poisoning following podophyllin treatment of condyloma acuminatum. South Med J 47:1204–1206
West WM, Ridgeway NA, Morris AJ (1982) Fatal Podophyllin ingestion. South Med J 75:1269–1270
Wisniewski H, Shelanski ML, Terry RD (1968) Effects of mitotic spindle inhibitors on neurotubules and neurofilaments in anterior horn cells. J Cell Biol 38:224–229
Zakon SJ (1952) Discovery of podopophyllum resin. Arch Dermatol Syphilol 65:620–622
Zweig MH, Chignell CF (1973) Interaction of some colchicine analogs, vinblastine and podophyllotoxin with rat brain microtubule protein. Biochem Pharmacol 22:2141–2150
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O'Mahony, S., Keohane, C., Jacobs, J. et al. Neuropathy due to podophyllin intoxication. J Neurol 237, 110–112 (1990). https://doi.org/10.1007/BF00314673
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DOI: https://doi.org/10.1007/BF00314673