Podophyllum Toxicity: A Report of a Fatal Case and a Review of the Literature

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Abstract
A 59-yr-old male ingested 10 g of podophyllum in a fatal suicide attempt. Previously unreported nuclear and cytoplasmic changes were observed in circulating leukocytes. Symptoms did not occur until 10 h after ingestion with loss of reflexes, coma, and a marked lactic acidosis. Despite hemoperfusion, the patient expired 39 h after ingestion. The literature on podophyllum toxicity is reviewed. Podophyllum is commonly used in the topical treatment of warts and condylomata. Systemic toxicity may result from either topical exposure or ingestion of this alkaloid. The toxicity of podophyllum is multisystemic with characteristic neurologic manifestations. A case is reported.