Tainted Castor Oil for Cosmetic Use Causes Kidney Failure

NASHVILLE—In an effort to save money and protect his privacy, a young transgender man sought the services of an unlicensed “cosmetic” practitioner, who used ricinine-contaminated castor oil to perform buttock augmentation, which caused kidney failure that required nearly four months’ dialysis before normal kidney function was restored.

“Silicone has been used to augment breast and buttocks in the past, but because of the cost ... people have tried different alternatives, such as castor oil,” wrote Dr. Dharmeshkumar Sutariya and Dr. George Coritsidis in the abstract for their presentation at the National Kidney Foundation’s Spring Clinical Meeting.

Sutariya and Coritsidis are affiliated with the Mount Sinai School of Medicine and ElmhurstHospitalCenter in Elmhurst, New York.

“This 25-year-old man went to someone’s basement—he never did give the full address—where he paid $50 to have castor oil injected,” said Sutariya.

Two days later, he was hospitalized with bilateral buttock pain, diffuse abdominal pain, nausea, vomiting and hematuria. Initial lab results showed acute kidney failure with thrombocytopenia and liver failure.

He subsequently was put on dialysis. He was discharged after a week, with outpatient dialysis required for nearly four months as his kidney function slowly improved.

A toxicology report on injected material recovered from his home showed the presence of ricinine, the alkaloid of castor bean plants which, when ingested, can cause liver and kidney damage, convulsions, hypotension and death.

For anyone contemplating an augmentation procedure, Sutariya said, “Please seek a cosmetic physician’s advice before you do anything to your body.”

He reminded clinicians that any case of acute kidney injury should be investigated and if necessary, public health officials should be alerted.