Arylnaphthalide Lignan
Definition
A plant secondary metabolite class to which the cleistanthins (Cleistanthus collinus toxins) belong. The cleistanthins damage the distal renal tubule, producing a type 1 distal renal tubular acidosis with profound hypokalaemia and multi-organ failure.
- Class
- Plant secondary metabolite
- Example toxins
- Cleistanthins (Cleistanthus collinus)
- Target
- Distal renal tubule
- Clinical effect
- Type 1 distal renal tubular acidosis, hypokalaemia
Common questions
Why does Cleistanthus collinus poisoning matter in a forensic context?+
It is used in parts of South Asia as a means of self-harm, and its clinical picture, profound hypokalaemia with distal renal tubular acidosis, can be mistaken for other causes of electrolyte derangement if the plant exposure is not identified early.
How does the renal tubular effect lead to multi-organ failure?+
The toxin's damage to the distal tubule disrupts acid-base and potassium handling severely enough that the resulting hypokalaemia and acidosis can precipitate cardiac arrhythmia and muscle weakness, cascading into failure of other organ systems if untreated.
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