Pyrrolizidine poisoning: a neglected area in human toxicology.

Pyrrolizidine poisoning in humans is regarded by most clinical toxicologists as of little relevance. However, a number of individual case studies in the West and some severe cases of mass poisoning by contaminated grains have led to increased interest in these alkaloids. The increasing use of herbal remedies, some of which contain toxic pyrrolizidines, suggests that the incidence of pyrrolizidine poisoning is likely to increase. In this review the authors describe the chemistry and metabolism of pyrrolizidine alkaloids, the salient features of pyrrolizidine poisoning, and the methods available for detection of these compounds in human fluids.