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Two cases of anticholinergic syndrome associated with consumption of bitter lupin flour

Nevada M Pingault, Robyn A Gibbs, Alexander M Barclay and Mark Monaghan
Med J Aust 2009; 191 (3): 173-174.

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  • Nevada M Pingault1
  • Robyn A Gibbs1
  • Alexander M Barclay2
  • Mark Monaghan3

  • 1 Communicable Disease Control Directorate, WA Health, Perth, WA.
  • 2 City of Perth, Perth, WA.
  • 3 Sir Charles Gairdner Hospital, Perth, WA.


Acknowledgements: 

We are grateful for the assistance of Bill Calder, Food Unit, WA Health; David Harris, Chemistry Centre WA; and Lynda Yeo, Emergency Physician, WA Health. The OzFoodNet enhanced foodborne disease surveillance program is funded by the Australian Government Department of Health and Ageing.

Competing interests:

None identified.

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  • 2. Hall RS, Thomas SJ, Johnson SK. Australian sweet lupin flour addition reduces the glycaemic index of a white bread breakfast without affecting palatability in healthy human volunteers. Asia Pac J Clin Nutr 2005; 14: 91-97.
  • 3. Lee YP, Mori TA, Sipas S, et al. Lupin-enriched bread increases satiety and reduces energy intake acutely. Am J Clin Nutr 2006; 84: 975-980.
  • 4. Archer BJ, Johnson SK, Devereux HM, et al. Effect of fat replacement by inulin or lupin-kernal fibre on sausage patty acceptability, post-meal perceptions of satiety and food intake in men. Br J Nutr 2004; 91: 591-599.
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  • 6. Peeters KABM, Nordlee JA, Penninks AH, et al. Lupine allergy: not simply cross-reactivity with peanut or soy. J Allergy Clin Immunol 2007; 120: 647-653.
  • 7. Australia New Zealand Food Authority. Lupin alkaloids in food. A toxicological review and risk assessment. Technical report series no. 3. Canberra: ANZFA, 2001. http://www.foodstandards.gov.au/_srcfiles/TR3.pdf (accessed Jun 2009).
  • 8. Burkhart KK. The anticholinergic patient. In: Dart RC, Caravati EM, McGuigan MA, et al, editors. Medical toxicology. 3rd ed. Philadelphia: Lippincott Williams and Wilkins, 2004: 51-53.
  • 9. Kurzbaum A, Safori G, Monir M, et al. Anticholinergic syndrome in response to lupin seed toxicity. Isr J Emerg Med 2008; 8: 20-22.
  • 10. Di Grande A, Paradiso R, Amico S, et al. Anticholinergic toxicity associated with lupin seed ingestion: case report. Eur J Emerg Med 2004; 11: 119-120.
  • 11. Tsiodras S, Shin RK, Christian M, et al. Anticholinergic toxicity associated with lupine seeds as a home remedy for diabetes mellitus. Ann Emerg Med 1999; 33: 715-717.
  • 12. Litkey J, Dailey MW. Anticholinergic toxicity associated with the ingestion of lupini beans. Am J Emerg Med 2007; 25: 215-217.
  • 13. Lowen RJ, Alam FKA, Edgar JA. Lupin bean toxicity. Med J Aust 1995; 162: 256-257.

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