She Has The Blues: An Unusual Case of Copper Sulphate Intoxication

Abstract

Background: Copper is an essential trace element of the human body. However, it is related to many diseases. Copper intoxication is not common in Western countries, but needs to be rapidly recognised because of its high lethality. Case presentation: We report the case of a 40-year-old woman who presented to the emergency department after performing intrarectal administration of a blue powder sent from Cameroon by her family, in the belief that this would help her to get pregnant. Her evolution was complicated by multiorgan failure and the unusual circumstances. The diagnosis was suspected on the basis of the clinical presentation and the colour of the powder, and confirmed by blood dosage and toxicological analysis of the powder. She underwent symptomatic treatment, and the outcome was progressively favourable, apart from persistent chronic renal failure with dependence on dialysis. Conclusion: Copper intoxications are rare but severe. Laboratory diagnosis of the condition is not an issue; the difficulty is suspecting it and quickly initiating chelation treatment associated with symptomatic treatments.

Acute poisoning of copper sulfate: a case report and review literature

“…D-penicillamine, dimercaprol, and edentate calcium diphosphate (EDTA) can chelate copper and enhance its elimination by the urinary tract. In our case, because the result of the blood analysis did not reveal copper level in the toxic range, chelation therapy was not performed [7,10]. Andreja SINKOVIC et al reported that the use of 2,3-dimercaptopropane-l-sulphonate (DMPS) was beneficial in the treatment of intentional oral poisoning [26].…”

“…The duodenum function in reabsorbing the bile and pancreatic secretions plays an important role in the complexity of the analysis of copper bioavailability. Elimination through the kidneys only consists of a small part (< 5%) [10].…”

“…The main complications of copper sulfate ingestion include intravascular hemolysis, methemoglobinemia, acute kidney injury, and rhabdomyolysis which is explained in detail below. Severe gastrointestinal effects may occur with acute overdosage [10]. In extreme or long-term overdosage, symptoms may be similar to those of Wilson's disease, a disease in which the liver does not filter copper adequately and copper accumulates in the liver, brain, eyes, and other organs [13].…”

Severe copper sulphate poisoning: A case rescued with plasmapheresis

“…2 A high concentration of copper ions depletes cellular glutathione stores with subsequent production of reactive oxygen species, leading to oxidative stress and membrane toxicity in red cells, hepatocytes, myocytes, and other cells. 1,3…”

Copper-induced Haemolytic Anaemia

“…Free copper binds to albumin forming its toxic form [2] . Blue-green material in emesis or stool is highly suggestive of copper ingestion and can be the only clue to diagnosis [3,4] . In this case, it was possible to confirm the drugs ingested, which is important for clinical management.…”