Lathyrism
SpecialtyToxicology
SymptomsWeakness, fatigue, paralysis of the legs, atrophy of leg muscles, and skeletal deformities
Usual onsetGradual
DurationPermanent
TypesNeurolathyrism
Osteolathyrism
Angiolathyrism
CausesOverconsumption of Legumes containing ODAP (neurolathyrism) or beta-aminopropionitrile (angio- and osteolathyrism)
Diagnostic methodBased on symptoms and diet
TreatmentSupportive care
FrequencyRare

Lathyrism is a condition, caused by eating certain legumes of the genus lathyrus. There are three types of lathyrism: neurolathyrism, osteolathyrism, and angiolathyrism. All of which are permanent but differ in symptoms and the affected tissues.[1]

Neurolathyrism is the type associated with the consumption of legumes in the genus lathyrus that contain the toxin ODAP. ODAP ingestion results in motorneuron death. The result is paralysis and muscle atrophy of the lower limbs. Osteolathyrism, a different type of lathyrism, affects the connective tissues, not the motorneurons.[2] Osteolathyrism results from the ingestion of lathyrus odoratus seeds (sweet peas) and is often referred to as odoratism. It is caused by a different toxin (beta-aminopropionitrile), which affects the linking of collagen, a protein of connective tissues. Another type of lathyrism is angiolathyrism, which is similar to osteolathyrism in its effects on connective tissue by means of the toxin beta-aminopropionitrile. However, the blood vessels are affected as opposed to bone.

Types[edit]

Neurolathyrism[edit]

Neurolathyrism is caused by the consumption of large quantities of Lathyrus grain, specifically the grains in the genus that contain the glutamate analogue neurotoxin ODAP (also known as β-N-oxalyl-amino-L-alanine, or BOAA). Lathyrus sativus (also known as grass pea, chickling pea, kesari dal, or almorta) and to a lesser degree with Lathyrus cicera, Lathyrus ochrus and Lathyrus clymenum[3]

Osteolathyrism[edit]

Osteolathyrism affects the bones and connecting tissues, instead of the nervous system. It is a skeletal disorder. It is caused by the toxin beta-aminopropionitrile which inhibits the copper-containing enzyme lysyl oxidase, responsible for cross-linking procollagen and proelastin. BAPN is also a metabolic product of a compound present in sprouts of grasspea, pea and lentils.[4]

Angiolathyrism[edit]

Angiolathyrism affects the collagen in blood capillaries. It is also caused by the toxin beta-aminopropionitrile.

Prevention[edit]

Eating the chickling pea with grain having high concentrations of sulphur-based amino acids reduces the risk of lathyrism if grain is available. Some states in India have banned the sale of Lathyrus legumes inorder to prevent the consumption of them, which in turn lessons the possibility of lathyrism in the general population.[5]

History[edit]

The first mentioned intoxication goes back to ancient India and also Hippocrates mentions a neurological disorder 46 B.C. in Greece caused by Lathyrus seed.[6] Lathyrism was occurring on a regular basis.

During the Spanish War of Independence against Napoleon, grasspea served as a famine food. This was the subject of one of Francisco de Goya's famous aquatint prints titled Gracias a la Almorta ("Thanks to the Grasspea"), depicting poor people surviving on a porridge made from grasspea flour, one of them lying on the floor, already crippled by it.

During WWII, on the order of Colonel I. Murgescu, commandant of the Vapniarka concentration camp in Transnistria, the detainees - most of them Jews - were fed nearly exclusively with fodder pea. Consequently, they became ill from lathyrism.[7]

In the film Ashes [English title] by Andrzej Wajda based on the novel Popioly [Polish title] translated as Lost army [English title] by Stefan Żeromski spanning the period 1798–1812, a horse is poisoned by grain from a Spanish village. The footage of the horse losing control of its hind legs suggests that it was fed with Almortas.

Association with famine[edit]

Ingestion of legumes containing the toxin occurs, although knowledge of how to detoxify Lathyrus is present, but drought conditions can lead to fuel and water shortages preventing the necessary steps from being taken, particularly in impoverished countries.[8] Lathyrism usually occurs where the despair of poverty and malnutrition leaves few other food options.

Related conditions[edit]

Disorders that are clinically similar are konzo and Lytico-bodig disease.

References[edit]

  1. ^ "Lathyrus". AACC. The American Association for Clinical Chemistry (AACC). Retrieved 30 July 2020.
  2. ^ Ahmad, Kamal (1982). Adverse Effects of Foods. Springer, Massachusettes: Springer US. pp. 71–2. ISBN 978-1-4613-3359-3. Retrieved 30 June 2020.
  3. ^ "Medical problems caused by plants: Lathyrism" at Prince Leopold Institute of Tropical Medicine online database
  4. ^ COHN, D.F. (1995) "Are other systems apart from the nervous system involved in human lathyrism?" in Lathyrus sativus and Human Lathyrism: Progress and Prospects. Ed. Yusuf H, Lambein F. University of Dhaka. Dhaka pp. 101-2.
  5. ^ Singh, S. P.; Bhawnani, Dhiraj; Parihar, Ajit; Verma, Nirmal (15 September 2016). "An epidemiological study on incidence and determinants of Lathyrism". The Journal of Community Health Management. 3 (3): 113–122. ISSN 2394-2738. Retrieved 2 July 2020.
  6. ^ Mark V. Barrow; Charles F. Simpson; Edward J. Miller (1974). "Lathyrism: A Review". The Quarterly Review of Biology. 49 (2): 101–128. doi:10.1086/408017. JSTOR 2820941. PMID 4601279.
  7. ^ isurvived.org: The Holocaust in Romania Under the Antonescu Government, by Marcu Rozen.
  8. ^ Cite error: The named reference patient was invoked but never defined (see the help page).