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Vol. 51. Núm. 7.
Páginas 418-425 (agosto 2004)
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Vol. 51. Núm. 7.
Páginas 418-425 (agosto 2004)
Acceso a texto completo
Enfermedades neurológicas asociadas al consumo de variedades de mandioca con alto contenido en gluconitrilos
Neurological diseases associated with intake of cassava varieties with high gluconitrile content
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J. Llorens
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jllorens@ub.edu

Correspondencia: Dr. J. Llorens. Departament de Ciències Fisiològiques II. Universitat de Barcelona. Feixa Llarga, s/n. 08907 L'Hospitalet de Llobregat. Barcelona. España
Departament de Ciències Fisiològiques II. Universitat de Barcelona. Barcelona. España
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Food plants often contain toxic compounds. Food processing is normally adapted to ensure safe consumption. However, in some circumstances, these toxic compounds cause diseases, especially neurological disorders. An important example is that of cassava, the main source of starch in many tropical regions. Cassava contains two gluconitrile, linamarin and lotaustralin, which can break down to cyanide. Epidemiological data associate cassava consumption with hypothyroidism and with two very different neurological diseases. These are tropical ataxic neuropathy (TAN), a polyneuropathy with sensorineural hearing loss and optic atrophy, and konzo, a spastic paraparesis. TAN and konzo are associated with two distinct patterns of cassava consumption. TAN is a chronic disease, appearing in people over 40 years old is areas of Nigeria in which a monotonous diet with cassava as the main component is common. Konzo affects mainly women and children; it appears abruptly during periods of alimentary in which cassava is almost the only food available. The pathogenic mechanisms of both TAN and konzo are unknown. The dietary origin of TAN has not yet been fully demonstrated. There is no doubt that konzo is a toxic-nutritional disease associated with cassava; however, the simplest hypothesis attributing a causal role to cyanide does not seem valid.

Key words:
Neurotoxicity syndromes
Plant poisoning
Spastic paraparesis
Gait ataxia
Malnutrition
Manihot
Glucosides
Nitriles

Los alimentos vegetales contienen, con frecuencia, compuestos tóxicos. En condiciones normales, el procesamiento de dichos alimentos está adaptado para permitir su consumo seguro. Sin embargo, en determinadas circunstancias, estos tóxicos provocan la aparición de enfermedades, entre las que destacan las de tipo neurológico. Un caso importante es el de la mandioca o yuca, la principal fuente de fécula en múltiples regiones tropicales. La mandioca contiene los gluconitrilos linamarina y lotaustralina, cuya degradación genera cianuro. Datos epidemiológicos asocian el consumo de mandioca a hipotiroidismo y a 2 enfermedades neurológicas muy diferentes entre sí: la neuropatía atáxica tropical, una polineuropatía periférica que cursa con sordera sensitivoneural y atrofia óptica, y el konzo, una paraparesia espástica. La neuropatía atáxica tropical y el konzo se asocian a 2 patrones diferentes de consumo de mandioca. La neuropatía atáxica tropical es una enfermedad crónica, que se presenta en personas de más de 40 años en determinadas regiones de Nigeria en las que se da una dieta monótona predominada por la mandioca. El konzo es una enfermedad que afecta preferentemente a niños y mujeres y que aparece de forma abrupta en períodos de crisis alimentaria, en los que la mandioca se mantiene prácticamente como el único alimento disponible. La patogenia de ambas enfermedades sigue sin esclarecerse. Para la neuropatía atáxica tropical, su origen alimentario no está suficientemente demostrado. En el caso del konzo, el origen tóxico-nutricional y la vinculación con la mandioca parecen indudables; sin embargo, la hipótesis más simple, la que supone un papel causal del cianuro, no parece cierta.

Palabras clave:
Síndromes neurotóxicos
Intoxicación por plantas
Paraparesia espástica
Ataxia de la marcha
Malnutrición
Manihot
Glucósidos
Nitrilos
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Copyright © 2004. Sociedad Española de Endocrinología y Nutrición
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