Epidemic dropsy in India

Epidemic dropsy is a clinical state resulting from use of edible oils adult erated with Argemone mexicana oil. Sanguinarine and dehydrosanguinarine are two major toxic alkaloids of Argemone oil, which cause widespread capillar y dilatation, proliferation and increased capillary permeability. Leakage o f the protein-rich plasma component into the extracellular compartment lead s to the formation of oedema. The haemodynamic consequences of this vascula r dilatation and permeability lead to a state of relative hypovolemia with a constant stimulus for fluid and salt conservation by the kidneys. Illness begins with gastroenteric symptoms followed by cutaneous erythema and pigm entation. Respiratory symptoms such as cough, shortness of breath and ortho pnoea progressing to frank right-sided congestive cardiac failure are seen. Mild to moderate anaemia, hypoproteinaemia, mild to moderate renal azotemi a, retinal haemorrhages, and glaucoma are common manifestations. There is n o specific therapy. Removal of the adulterated oil and symptomatic treatmen t of congestive cardiac failure and respiratory symptoms, along with admini stration of antioxidants and multivitamins, remain the mainstay of treatmen t. Selective cultivation of yellow mustard, strict enforcement of the India n Food Adulteration Act, and exemplary punishment to unscrupulous traders a re the main preventive measures.