Severe Acute Copper Sulphate Poisoning: A Case Report

Abstract

As copper sulphate pentahydrate (CSP) is a common compound used in agriculture and industry, chronic occupational exposures to CSP are well known, but acute poisoning is rare in the Western world. This case report describes acute poisoning of a 33-year-old woman who attempted suicide by ingesting an unknown amount of CSP. On admission to the hospital, she had symptoms and signs of severe hemorrhagic gastroenteritis, dehydration, renal dysfunction and methaemoglobinaemia with normal serum copper level. Therapy included early gastric lavage, fluid replacement, vasoactive drugs, furosemide, antiemetic drugs, ranitidine, and antidotes methylene blue and 2,3-dimercaptopropane-1-sulphonate (DMPS). However, the patient developed severe intravascular haemolysis, acute severe hepatic and renal failure, as well as adrenal insufficiency. After prolonged, but successful hospital treatment, including haemodialysis and IV hydrocortisone, the patient was discharged with signs of mild renal and liver impairment. Our conclusion is that in severe cases of copper poisoning early supportive measures are essential. In addition, antidotes such as methylene blue for methaemoglobinaemia and chelating agent such as DMPS improve morbidity and survival of severely poisoned victims.

Acute Pancreatitis Complicated with Combined Copper Sulphate and Kerosene Poisoning –A Case Report

“…There was huge leucocytosis which can be due to acute pancreatitis or concomitant sepsis. This was also observed in other studies of severe copper sulphate poisoning 7,8 . The leucocytosis and Haemoglobin at follow up become normal indicating recovery from sepsis.…”

Complications and management of acute copper sulphate poisoning; a case discussion

“…Ingestion of more than 1 g of copper sulphate results in manifestation of symptoms of toxicity [2]. However, this is only a rough threshold for toxicity and depends on individual factors.…”

“…Liver gets damaged early in copper poisoning as the majority of absorbed copper is deposited in liver after being delivered from the portal circulation. Acute liver failure following tissue necrosis can occur due to direct copper toxicity [2,5]. …”

"Metallic taste": search for the needle in a haystack (exemplary diagnostic measures and successful minimal invasive endoscopic treatment of a needle-like copper-containing foreign body in the gastric wall)

“…Chronic metallic poisoning occurs rarely 1 – 3. In the majority of cases, it is the consequence of swallowing a copper coin4 , 5 by psychotic patients 1 – 3.…”

“…In the majority of cases, it is the consequence of swallowing a copper coin4 , 5 by psychotic patients 1 – 3. In former times, copper overload was generated by drinking out of copper-containing pots and using copper-containing water supplies.…”