Endosulfan Poisoning with Intravascular Hemolysis

Ramaswamy, Shankar; Puri, Goverdhan Dutt; Rajeev, Subramanyam

doi:10.1016/j.jemermed.2007.02.039

Cited by 5 publications

(4 citation statements)

References 9 publications

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“…This insecticide causes hyperexcitation in the central nervous system [11]. The major biochemical response to endosulfan is the inhibition of Na þ /K þ and Ca 2þ /Mg 2þ ATPase, essential for transportation of ions across membranes in mammals as well as in fish [12].…”

Section: Introductionmentioning

confidence: 99%

Oxidative stress in macrophages from spleen of Nile tilapia (Oreochromis niloticus) exposed to sublethal concentration of endosulfan

Téllez‐Bañuelos

Santerre

Casas‐Solís

et al. 2009

Fish & Shellfish Immunology

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Section: Introductionmentioning

confidence: 99%

Oxidative stress in macrophages from spleen of Nile tilapia (Oreochromis niloticus) exposed to sublethal concentration of endosulfan

Téllez‐Bañuelos

Santerre

Casas‐Solís

et al. 2009

Fish & Shellfish Immunology

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“…As a result, cases of endosulfan toxicity continue to be observed. Common causes of acute toxicity include suicide attempts (10-13), accidental ingestion via contaminated food (14-16), and agricultural misuse (4, 17). Clinically, the common manifestations of endosulfan ingestion include nausea, vomiting, headache, dizziness, agitation, seizures, respiratory depression, and coma.…”

Section: Introductionmentioning

confidence: 99%

Lethal Neurotoxicity Induced by Endosulfan Ingestion

Matshes

McKenzie

Lew

2012

Academic Forensic Pathology

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Endosulfan is a highly toxic agricultural pesticide that has been banned in many countries due to its significant neurotoxicity and environmental persistence. Accidental or intentional ingestion by humans induces severe neurological symptoms, which frequently culminate in coma or death. Forensic evaluation of suspected endosulfan toxicity cases can be challenging, given that endosulfan residue may not be detectable in the blood or tissues at the time of death. As such, evaluation of the case history in the context of the reported literature becomes extremely important. Although acute endosulfan toxicity in adults has been well documented, pediatric cases are rare within the literature. Here we present the case of a toddler who accidentally ingested an unknown quantity of endosulfan from an unmarked water bottle on his family farm. The child developed rapid-onset neurological symptoms, including vomiting and seizures, followed by coma. Despite medical intervention, the child was eventually pronounced brain dead and taken off life support. Autopsy revealed massive cerebral edema and its sequelae (sutural diastasis, pituitary necrosis, and dural venous thromboses), and pulmonary thromboemboli. Endosulfan was detected in the bottle from which the child drank. As endosulfan was not detectable in postmortem blood, the cause of death was certified based upon the totality of available information including history, consistency of the case history with the clinical presentation, and the autopsy findings.

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“…Mortality and morbidity rates are very high and there is no specific antidote. [5] Patients may present with severe metabolic acidosis. If severe metabolic acidosis is present, hemodialysis may be an important intervention and should be performed early.…”

Section: Introductionmentioning

confidence: 99%

High anion gap refractory metabolic acidosis as a critical presentation of endosulfan poisoning

et al. 2011

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Organochloride insecticides are chlorinated cyclic hydrocarbons. One of such insecticides is endosulfan (6,7,8,9,10-10 hexachloro 1,5,5a,6,9,9a-hexahydro-6-methano-2,4,3-hexadithioxanthiep in 3-oxide) and it has been widely used in agriculture since 1960. The uncontrolled use of these compounds in developing countries has resulted in the deaths of animals and humans. Characteristic clinical signs following acute exposure are indicative of CNS disturbances or overstimulation. Mortality and morbidity rates are high and there is no specific antidote. We present an uncommon presentation of endosulfan poisoning in a 32-year-old male with high anion gap severe refractory metabolic acidosis. The patient was treated with continuous renal replacement therapy and was salvaged. Till date, there is no case report from India for endosulfan poisoning with severe metabolic acidosis and hypotension. Through this case report, we emphasize the role of continuous renal replacement therapy as a rescue therapy for endosulfan poisoning with severe refractory metabolic acidosis and hypotension, even though it is a non dialyzable poison.

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Endosulfan Poisoning with Intravascular Hemolysis

Cited by 5 publications

References 9 publications

Oxidative stress in macrophages from spleen of Nile tilapia (Oreochromis niloticus) exposed to sublethal concentration of endosulfan

Oxidative stress in macrophages from spleen of Nile tilapia (Oreochromis niloticus) exposed to sublethal concentration of endosulfan

Lethal Neurotoxicity Induced by Endosulfan Ingestion

High anion gap refractory metabolic acidosis as a critical presentation of endosulfan poisoning

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