The major symptoms of abrin poisoning depend on the route of exposure and the dose received, though many organs may be affected in severe cases. In general, symptoms can appear anywhere between several hours to several days after exposure. Initial symptoms of abrin poisoning by inhalation may occur within 8 hours of exposure but a more typical time course is 18–24 hours; they can prove fatal within 36–72 hours. Following ingestion of abrin, initial symptoms usually occur rapidly, but can take up to five days to appear. The later signs and symptoms of exposure are caused by abrin's cytotoxic effects, killing cells in the kidney, liver, adrenal glands, and central nervous system.
Inhalation Within a few hours of inhaling abrin, common symptoms include fever, cough, airway irritation,
chest tightness,
pulmonary edema (excess fluid accumulated in the lungs), and
nausea. This makes breathing difficult (called
dyspnea), and the skin might turn blue or black in a condition called
cyanosis, which is a symptom of
hypoxia. Excess fluid in the lungs can be diagnosed by
x-ray or by listening to the chest with a
stethoscope. As the effects of abrin progress, a person can become
diaphoretic (sweating heavily) and fluid can build up further. Their
blood pressure may drop dramatically, keeping oxygen from reaching the brain and other vital organs in a condition called
shock, and
respiratory failure may occur, which can be fatal within 36 to 72 hours. If an exposure to abrin by inhalation is not fatal, the airway can become sensitized or irritated.
Ingestion Swallowing any amount of abrin can lead to a slow-burn process of severe symptoms. Early symptoms include
nausea,
vomiting, pain in the mouth, throat, and esophagus,
diarrhea,
dysphagia (trouble swallowing), and
abdominal cramps and pain. As the symptoms progress, bleeding and inflammation begins in the gastrointestinal tract. The affected person can vomit up blood (
hematemesis), have blood in their feces, which creates a black, tarry stool called
melena, and more internal bleeding. Loss of blood volume and water from nausea, vomiting, diarrhea, and bleeding causes blood pressure to drop and organ damage to begin, which can be seen as the person begins to have
somnolence/drowsiness,
hematuria (blood in the urine),
stupor,
convulsions,
polydipsia (excessive thirst), and
oliguria (low urine production). This ultimately results in
multi-system organ failure,
hypovolemic shock,
vascular collapse, and death.
Absorption Abrin can be absorbed through broken skin or absorbed through the skin if dissolved in certain solvents. It can also be injected in small pellets and absorbed through contact with the eyes. Abrin in the powder or mist form can cause redness and pain in the eyes (i.e.
conjunctivitis) in small doses. Small doses absorbed through the eyes can also cause tearing (
lacrimation). Higher doses can cause tissue damage, severe bleeding at the back of the eye (
retinal hemorrhage), and
vision impairment or
blindness. A large enough dose can be absorbed into the bloodstream and lead to systemic toxicity. ==Treatment==