Anticholinergic Toxicity Associated with Lupine Seeds Ingestion—A Case Report

Lupine, a member of the legume family, is also known as lupines in the USA and as Turmus in the Middle East. Lupine seeds are consumed as an appetizer and in herbal therapy for diabetes mellitus in the Middle East. Quinolizidine alkaloids are found in various plants belonging to the Lupinus genus although the nature and level of these alkaloids are highly variable between species; these compounds are known to cause anticholinergic symptoms. We present a case for a 40-year old woman who presented with blurry vision, nausea, abdominal pain, dizziness, disorientation, and severe mouth dryness for one hour prior to presentation.  She ate partially debittered lupine seeds about an hour prior to her complaints. On physical exam, she was found to have sinus tachycardia, bilateral fixed dilated pupils and facial flushing. Lab tests and brain imaging were unremarkable, and the lupine seeds ingestion was presumed to be the cause of her complaints. She was admitted for observation for 24 hours and her symptoms resolved spontaneously.