Torsades de pointes in amitraz poisoning

Hu, Sung-Yuan; Hsu, Chia-Lung; Tsan, Yu‐Tse; Hung, Dong-Zong; Hu, Wei-Hsiung; Li, Hongping

doi:10.1016/j.resuscitation.2009.11.009

Cited by 10 publications

(13 citation statements)

References 5 publications

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“…Importantly, the serum cholinesterase levels are normal with amitraz poisoning, while they are low in the case of OPC poisoning 5. Gas chromatography-mass spectrometry and gas liquid chromatography may be employed to measure the levels of amitraz and its metabolites in the serum and urine, but are not available in day-to-day practice 2 10 12…”

Section: Discussionmentioning

confidence: 99%

Amitraz: a mimicker of organophosphate poisoning

2015

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Amitraz is used as an ectoparasiticide for dogs and cattle. Human poisoning due to amitraz may be misdiagnosed as organophosphate/carbamate (OPC) toxicity, since amitraz poisoning shares several clinical features (miosis, bradycardia and hypotension) encountered with OPC poisoning. A 19-year-old man with an alleged history of suicidal ingestion of a pesticide presented with drowsiness and was found to have constricted pupils, hypotension and bradycardia. He was diagnosed as a case of OPC poisoning and was treated with atropine and pralidoxime prior to presentation to our centre. Absence of a hypersecretory state, and the presence of hyperglycaemia and hypothermia along with a normal serum cholinesterase level suggested an alternate possibility. Retrieval of the poison container confirmed the diagnosis of amitraz poisoning. The patient made a rapid recovery with supportive management. Clinician awareness is key to successful management of this poisoning, which carries a good prognosis.

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Section: Discussionmentioning

confidence: 99%

Amitraz: a mimicker of organophosphate poisoning

2015

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“…Twenty articles were excluded due to the following reasons: ( i ) four were abstracts 14 15 16 17 ; ( ii ) four had insufficient clinical details of cases 18 19 20 21 ; ( iii ) one report described cases, the details of whom were included in a later paper with a larger sample size 22 23 ; and ( iv ) 11 articles (33 patients) were published in a language other than English. The search thus yielded 32 studies reporting 310 cases of amitraz poisoning ( Table I ) 1 3 4 5 7 8 9 10 11 12 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 . Three cases from the series described by Bonsall and Turnbull 7 were excluded due to lack of clinical data.…”

Section: Resultsmentioning

confidence: 99%

Amitraz, an underrecognized poison: A systematic review

Dhooria¹,

Agarwal²

2016

Indian J Med Res

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Background & objectives:Amitraz is a member of formamidine family of pesticides. Poisoning from amitraz is underrecognized even in areas where it is widely available. It is frequently misdiagnosed as organophosphate poisoning. This systematic review provides information on the epidemiology, toxicokinetics, mechanisms of toxicity, clinical features, diagnosis and management of amitraz poisoning.Methods:Medline and Embase databases were searched systematically (since inception to January 2014) for case reports, case series and original articles using the following search terms: ‘amitraz’, ‘poisoning’, ‘toxicity’, ‘intoxication’ and ‘overdose’. Articles published in a language other than English, abstracts and those not providing sufficient clinical information were excluded.Results:The original search yielded 239 articles, of which 52 articles described human cases. After following the inclusion and exclusion criteria, 32 studies describing 310 cases (151 females, 175 children) of human poisoning with amitraz were included in this systematic review. The most commonly reported clinical features of amitraz poisoning were altered sensorium, miosis, hyperglycaemia, bradycardia, vomiting, respiratory failure, hypotension and hypothermia. Amitraz poisoning carried a good prognosis with only six reported deaths (case fatality rate, 1.9%). Nearly 20 and 11.9 per cent of the patients required mechanical ventilation and inotropic support, respectively. The role of decontamination methods, namely, gastric lavage and activated charcoal was unclear.Interpretation & conclusions:Our review shows that amitraz is an important agent for accidental or suicidal poisoning in both adults and children. It has a good prognosis with supportive management.

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“…También se ha reportado su capacidad para inhibir la MAO, in vivo, pero no in vitro 11,12 . Se encuentran reportes de casos en los que hay manifestaciones como arritmias de puntas torcidas 13 o síndrome de Ogilvie, un tipo de pseudoparálisis intestinal 14 .…”

Section: Declaración De Conflicto De Interesesunclassified

Reporte de caso de intoxicación por amitraz

Rosas¹,

Mejía²

2017

MedUPB

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RESUMENLa intoxicación por amitraz es poco frecuente en Colombia. Los objetivos de este reporte de caso son evidenciar una presentación atípica de la intoxicación en un paciente de edad avanzada y resaltar aspectos toxico-cinéticos y toxico-dinámicos asociados. La literatura consiste, principalmente, en reportes de caso y series de casos y en Norteamérica. Existe la necesidad de que el personal de salud involucrado en el manejo de estos pacientes reconozca aspectos clave de su fisiopatología y tratamiento. El caso reportado es de un paciente masculino de 73 años, intoxicado por amitraz, que se presenta inicialmente sin alteraciones, y luego de 33 horas, presenta alteraciones del sensorio y compromiso respiratorio, por lo que requiere una disposición en Unidad de Cuidados Especiales (UCE). El paciente tiene evolución satisfactoria. Palabras clave: insecticidas; envenenamiento; fisiopatología. ABSTRACTAmitraz poisoning is not frequent in Colombia. The objectives of this case report are to consider the atypical poisoning in an elderly patient and to emphasize the associated toxic-kinetic and toxic-dynamic aspects. The literature mainly consists of case reports and case series in North America. There is a need for the health personnel involved in the treatment of these patients to recognize key aspects of its physiopathology and treatment. The case reported involves a male patient aged 73 with amitraz poisoning, initially without alterations after 33 hours, presenting sensory alterations and respiratory compromise requiring attention in the Special Care Unit (SCU). The patient recovered satisfactorily. Keywords: insecticides; poisoning; physiopathology. RESUMOA intoxicação por Amitraze é pouco frequente na Colômbia. Os objetivos deste relato de caso são evidenciar uma apresentação atípica da intoxicação num paciente de idade avançada e ressaltar aspectos toxico-cinéticos e toxico-dinâmicos associados. A literatura consiste, principalmente, em relato de caso e séries de casos e na América do Norte. Existe a necessidade de que o pessoal da saúde envolvido no manejo destes pacientes reconheça aspectos chave da sua fisiopatologia e tratamento. O caso reportado é de um paciente masculino de 73 anos, intoxicado por amitraz, que se apresenta inicialmente sem alterações, e logo de 33 horas, apresenta alterações do sensório e compromisso respiratório, pelo qual requere uma disposição em Unidade de Cuidados Especiais (UCE). O paciente tem evolução satisfatória.

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Torsades de pointes in amitraz poisoning

Cited by 10 publications

References 5 publications

Amitraz: a mimicker of organophosphate poisoning

Amitraz: a mimicker of organophosphate poisoning

Amitraz, an underrecognized poison: A systematic review

Reporte de caso de intoxicación por amitraz

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