Cyanide toxicity in humans in India
1995
Shenoy, K.T. | Leena, K.B. (Medical Coll., Trivandrum 695017 (India). Dept. of Gastroenterology)
Case-control studies have shown that cassava in the diet is an important risk factor for tropical pancreatitis, and the experimental model with cassava-based protein and fat-modified diet have given evidence to support cassava hypothesis. Exocrine and endocrine pancreatic dysfunction and morphological changes in the acinar and islets similar to pancreatitis have been observed. Population-based studies in the tribal population in Kerala have shown that 77 percent consumed cassava cultivars with HCN content more than 100 ug/g in the fresh root. Exocrine pancreatic function was impaired in subject aged greater than or equal to 31 years who had consumed alcohol in addition to chronic cassava consumption. Prevalence of diabetes mellitus and impaired glucose tolerance was 3 percent in the same population. Endomyocardial fibrosis is highest in the population. Epidemiologic data, case-control studies and experimental studies favor the role of cassava in the etiopathogenesis. Seru rhodanese activity was significantly high in EMF [endomyocardial fibrosis] cases. Endomyocardial, perisvascular and chordae tendinea fibrosis have been noted in cassava-fed model with protein and fat modification. Left ventricular dysfunction and thickening and fibrosis by endocardium are seen in tropical pancreatitis. Reactive load by cyanogenic glucoside in cassava leads to excess of lipid peroxides; there is lack of antioxidants such as selenium, cystine and scavenging enzymes leading to hypoxic tissue injury and replacement fibrosis. The geographical epidemiology of EMF and tropical pancreatitis linked to chronic cassava consumption is probably the highest in Kerala. Consumption of well-cooked cassava with low HCN content and supplementation with protein and/or antioxidants can prevent these diseases
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