1 A 21 year-old student ingested thirty ricin seeds in a suicidal attempt, some of which were masticated. Three hours later he developed severe diarrhoea with vomiting and abdominal cramps, followed by extracellular dehydration and circulatory collapse. 2 Biological changes included haemoconcentration. He recovered following symptomatic treatment by infusion of saline and glucose solutions. 3 Ricin was quantified by a radioimmunologic method using Iodine 125, and showed that only a small part of the ricin contained in the seeds was absorbed.
1 The authors performed haemodynamic studies in 8 cases of colchicine poisoning. The doses absorbed ranged between 9 and 160 mg (mean dose 39 mg). The haemodynamic study was performed between the 6th and 72nd h after intoxication, before and after plasma infusion (370 ml over a period of 20 minutes). 2 Four patients had severe shock with decreased cardiac index (CI) and increased systemic vascular resistance (SVR). Four patients had a hyperkinetic state with increased CI and decreased SVR. The four patients with cardiac failure died, the others recovered. 3 Haemodynamic study of acute colchicine poisoning is of therapeutic and prognostic interest. Hypovolaemia is always present. An initial decrease of cardiac performance is an index of severity with a lethal outcome.
A 27 year-old man developed after ingestion of mercury chloride, 6 g, a hypovolemic shock, an acute renal failure and a necrosis of the stomach which required a total gastrectomy. The anuria did not improve and required 42 hemodialyses. Subsequent evolution showed numerous complications and the patient died on the 91st day. On admission mercury plasma concentration was 5 mg/L and decreased slowly with an apparent half-life of 226 hours. Hemodialyses were ineffective for mercury elimination: mercury clearances varied between -10 and + 1.5 ml/min. Seventeen mg of mercury were removed by six plasma exchanges: the mercury clearance was mean 17.3 ml/min. Among the extracorporeal elimination methods, plasma exchange appears to be the most efficient for inorganic mercury and it could be usefull in association with chelation therapy at the early phase of the intoxication.
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