Epidemic dropsy is a form of edema of extremities due to poisoning by Argemone mexicana (Mexican prickly poppy).

Other major symptoms are bilateral pitting edema of extremities, headache, nausea, loose bowels, erythema, glaucoma and breathlessness.

The haemodynamic consequences of this vascular dilatation and permeability lead to a state of relative hypovolemia with a constant stimulus for fluid and salt conservation by the kidneys.

Dropsy patients develop proteinuria specifically due to loss of albumin, with a resultant edema as would occur in nephrotic syndrome.

Major symptoms observed in patiesnts are bilateral pitting edema of extremities, headache, nausea, loose bowels, erythema, glaucoma and breathlessness.

In severe cases the before mentioned conditions will progress to frank right-sided congestive cardiac failure and death of the patient.

Argemone mexicana (family Papaveraceae), a native of West Indies and naturalized in India, is known as “Shailkanta” in Bengal and “Bharbhanda” in Uttar Pradesh.

Prior in vitro studies have shown that ROS are involved in AO induced toxicity causing peroxidative damage of lipids in various hepatic sub-cellular fractions including microsomes and mitochondria of rats.

[citation needed] Pulmonary toxicity: The decrease in glycogen levels following argemone oil intoxication could be due to enhanced glycogenolysis leading to the formation of glucose-1-phosphate, which enters the glycolytic pathway resulting in accumulation of pyruvate in the blood of experimental animals and dropsy patients.

It is well established that increased pyruvate concentration in blood uncouples oxidative phosphorylation, and this may be responsible for thickening of interalveolar septa and disorganized alveolar spaces in lungs of argemone oil-fed rats and the breathlessness as has been observed in human victims.

[7][8] The retention of sanguinarine in the gastrointestinal (GI) tract, liver, lung, kidney, heart and serum even after 96 hrs of exposure indicates these as the likely target sites of argemone oil toxicity.

Diuretics are used universally but caution must be exercised not to deplete the intravascular volume unless features of frank congestive cardiac failure are present, as edema is mainly due to increased capillary permeability.

[1] Besides India, widespread epidemics have been reported from Mauritius, Fiji Islands, Northwest Cape districts of South Africa, Madagascar and also from Nepal.