The trend of ammonia levels in patients with glufosinate ammonium poisoning with respect to neurotoxicity

Kim, Joochan; Cho, Yong Soo; Chun, Byeong Jo; Moon, Jeong Mi; Kim, Yon Su; Lee, Byung Kook; Lee, Dong Hun; Ryu, Seok Jin; Jung, Eujene

doi:10.1007/s00210-022-02327-y

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…Predicting fatal CNS toxicity solely based on initial blood ammonia levels measured upon the ED admission, except in cases with exceptionally high levels (at least >100 µg/dL), is challenging (88). As previously mentioned, in acute GAH poisoning, severe CNS toxicity symptoms and signs likely result from the stimulation of NMDA receptors by GAH or related metabolic products that have crossed the BBB.…”

Section: Hyperammonemiamentioning

confidence: 99%

“…Even though the blood ammonia concentration in patients with acute GAH poisoning may not accurately reflect the CNS ammonia level, it is necessary to monitor the plasma ammonia level from the ED admission (88,(97)(98)(99). This is because changes in plasma ammonia concentration can provide some estimation of the worsening or improvement of CNS toxicity symptoms in acute GAH poisoning (79,100).…”

Section: Figure 4 Clinical Progress Of Acute Gah Poisoningmentioning

confidence: 99%

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A Narrative Review of Contemporary Lethal Pesticides: Unveiling the Ongoing Threat of Pesticide Poisoning

Choi,

Kim,

Lim

2024

Clin Exp Emerg Med

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Following the 2011 ban on paraquat sales, South Korea has witnessed a significant reduction in the mortality rate associated with acute pesticide poisoning (1). Traditionally, paraquat and diquat, alongside several highly toxic organophosphates, carbamates, and organochlorine insecticides, have been recognized as culprits in causing fatalities among patients with acute pesticide poisoning (2,3).However, despite global efforts to curtail the use of these highly toxic pesticides, certain pesticides still exhibit a level of lethality surpassing their established clinical toxicity profiles (1-6). Understanding the clinical progression of these pesticides is paramount for physicians and toxicologists, as it holds the potential to enhance patient prognoses in cases of acute poisoning. This review aims to address the persistence of such highly lethal pesticides, which continue to pose a grave threat to victims of acute poisoning.

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Section: Hyperammonemiamentioning

confidence: 99%

Section: Figure 4 Clinical Progress Of Acute Gah Poisoningmentioning

confidence: 99%

A Narrative Review of Contemporary Lethal Pesticides: Unveiling the Ongoing Threat of Pesticide Poisoning

Choi,

Kim,

Lim

2024

Clin Exp Emerg Med

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Sensitive fluorescence detection of glyphosate and glufosinate ammonium pesticides by purine-hydrazone-Cu2+ complex

Tao,

Mao,

Alam

et al. 2024

Spectrochimica Acta Part A: Molecular and Biomolecular Spectros

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Clinical features of acute glufosinate ammonium and initial serum ammonia and CK-MB as early predictors of unfavorable prognosis

Xue,

Xie,

Shen

et al. 2024

Preprint

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This retrospective study was conducted on 67 patients who suffered from acute oral glufosinate ammonium poisoning to summarize a comprehensive overview of the clinical characteristics. General clinical data and laboratory test results were collected from the time of admission to hospital discharge. The most common clinical symptom of GA poisoning were nausea and vomiting, The incidence of unfavorable outcomes and the mortality of GA poisoning were 41.8% and 13.4%. The unfavorable outcomes group had a higher initial serum ammonia level (75.7±17.3umol/L vs 47.5±12.8umol/L, P<0.001), more ingestion amount of GA (103.6±63.4ml vs 72.3±37.7ml, P=0.032) and higher-level CK-MB (43.5 U/L vs 16.0 U/L, P=0.002) compared to favorable outcomes groups. Multiple logistic regression analyses showed the initial serum ammonia (OR=1.031, 95%CI, 1.069-1.197, P<0.001)，ingestion amount of GA (OR=1.017, 95%CI, 0.997-1.039, P=0.013) and CK-MB (OR=1.017, 95%CI, 0.997-1.039, P=0.013) levels were independently associated with unfavorable outcomes. Receive operator characteristic (ROC) curves were used to determine the optimal initial serum ammonia level (62.7mmol/L with sensitivity of 85.7% and specificity of 87.2%, and AUC=0.873, 95%CI, 0.773-0.974, P<0.001), CK-MB level (43.5U/L with sensitivity of 42.9% and specificity of 87.2%, and AUC=0.680, 95%CI, 0.562-0.809, P=0.012) and the ingestion amount(110ml with sensitivity of 32.1% and specificity of 92.3%, and AUC=0.652, 95%CI, 0.518-0.786, P=0.035) respectively.The patients with GA poisoning may exhibit clinical symptoms of gastrointestinal and neurological toxicity, as well as respiratory failure after latent period that we need to pay special attention to prepare. Initial serum and CK-MB might be better accurate prognostic factors for predicting the unfavorable outcomes.

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The trend of ammonia levels in patients with glufosinate ammonium poisoning with respect to neurotoxicity

Cited by 4 publications

References 18 publications

A Narrative Review of Contemporary Lethal Pesticides: Unveiling the Ongoing Threat of Pesticide Poisoning

A Narrative Review of Contemporary Lethal Pesticides: Unveiling the Ongoing Threat of Pesticide Poisoning

Sensitive fluorescence detection of glyphosate and glufosinate ammonium pesticides by purine-hydrazone-Cu2+ complex

Clinical features of acute glufosinate ammonium and initial serum ammonia and CK-MB as early predictors of unfavorable prognosis

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