SavedAdd your journal

Journals / Harran Üniversitesi Tıp Fakültesi Dergisi / 2015 / Cilt: 12 - Sayı: 3

Late and Interrupted Oxime Therapy In An Intermediate Syndrome Following Chlorpyrifos Poisoning: Case Report

Klorprifos Zehirlenmesini Takiben Gelişen Intermediate Sendromda Geç ve Aralıklı Oksim Tedavisi: Olgu Sunumu

Başak Ceyda MECO
Melek TULUNAY
Esra ÖZAYAR
Şaban YALÇIN
Şirali OBA
Necmettin ÜNAL
Mehmet ORAL
Pages
383–388
Publication Date
2015-12-30
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

This case suggests that patients suffering from chlorpyrifos intoxication can be under the risk of IMS.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Intermediate syndrome (IMS) is characterized by weakness of proximal limb and respiratory muscles, neck flexors, and cranial nerves.
📊
Key Findings & Data:We report a case of 56-year-old man who developed an IMS after chlorpyrifos ingestion.
💡
Conclusion & Impact:This case suggests that patients suffering from chlorpyrifos intoxication can be under the risk of IMS.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Zehirlenmeler · Klorprifos · Oksimler

Abstract

Intermediate syndrome (IMS) is characterized by weakness of proximal limb and respiratory muscles, neck flexors, and cranial nerves. Several hypothesis have been developed to explain its etiology (neuromuscular junction disfunction, inadequate or late oxime therapy, prolonged and severe inhibition of acetylcholinesterase). Chlorpyrifos is a organophosphate with relatively low toxicity. IMS secondary to chlorpyrifos is very rare. We report a case of 56-year-old man who developed an IMS after chlorpyrifos ingestion. Although he presented with cholinergic symptoms initially, his mental and respiratory status deteriorated and profound motor paralysis consistent with IMS occurred on the second day. The patient required ventilatory support. Pralidoxime could only be administered late (52 hours post-ingestion), and intermittently for 23 days. The course of the patient was complicated with ventilator-associated pneumonia and septic shock, but after 32 days he was discharged. This case suggests that patients suffering from chlorpyrifos intoxication can be under the risk of IMS.

Özet

İntermediate sendrom (İMS) proksimal ekstremite ve solunum kaslarında, boyun fleksorlarında ve kranial sinirlerde zayıflıkla karakterizedir. Etyolojiyi açıklamak için birkaç hipotez geliştirilmiştir (nöromusküler bileşke disfonksiyonu, yetersiz veya geç oksim tedavisi, asetilkolinesterazın uzamış ve ciddi inhibisyonu). Klorprifos düşük toksisiteyle ilişkili organofosfattır. Klorprifosa sekonder İMS çok nadirdir. 56 yaşında erkek hastada klorprifos oral alımından sonra gelişen İMS'u sunuyoruz. Başlangıçta kolinerjik sendrom belirtileri gösteren hastada ikinci günde mental ve respiratuar durumu kötüleşip İMS'u düşündüren derin motor paralizi gelişti. Hastaya ventilatör desteği gerekti. Pralidoksim geç (oral alımdan 52 saat sonra) ve 23 günde aralıklı olarak verilebildi. Hastanın takiplerinde ventilatör ilişkili pnömoni ve septik şok gelişmesine rağmen 32. gününde taburcu edildi. Bu olgu klorprifos intoksikasyonlarıyla gelen hastalarda İMS riski olduğunu göstermektedir.

🔖

Cite This Article

MECO, B. C., TULUNAY, M., ÖZAYAR, E., YALÇIN, Ş., OBA, Ş., ÜNAL, N., ORAL, M. (2015). Late and Interrupted Oxime Therapy In An Intermediate Syndrome Following Chlorpyrifos Poisoning: Case Report. Harran Üniversitesi Tıp Fakültesi Dergisi, Cilt: 12 - Sayı: 3, 383–388. https://ajindex.com/articles/106887

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (16)

  1. Peter JN, Moran JL, Graham PM. Oxime Therapy and Outcomes in Human Organophosphate Poisoning: An Evaluation Using Meta-analytic Techniques. Crit Care Med 2006
  2. 34(2): 502-10. 2-Tunçok Y, Hocaoğlu Aksay N. Organofosfatlı İnsektisidlerle Zehirlenme. Turkiye Klinikleri J Surg Med Sci 2006
  3. 2(46): 69-73. 3-Sungur M, Guven M. Intensive care management of organophosphate insecticide poisoning. Crit Care 2001
  4. 5(4): 211-15. 4-Yang CC, Deng JF. Intermediate syndrome following organophosphate insecticide poisoning. J Chin Med Assoc. 2007
  5. 70(11): 467-72. 5-Senayake N, Karalliedde L. Neurotoxic effects of organophosphorus insecticides: an intermediate syndrome. N Eng J Med 1987
  6. 316(13): 761-63. 6-De Bleecker J, Van Den Neucker K, Willems J. The intermediate syndrome in organophosphate poisoning: presentation of a case and rewiev the literature. J Toxicol Clin Toxicol 1992
  7. 30(4): 321-29. 7-De Bleecker J, Ven Den Neucker K, Colardyn F. Intermediate syndrome in organophosphorus poisoning: a prospective study. Crit Care Med 1993
  8. 21(11):1706- 11. 8-He Fu, Xu H, Qin F, Xu L, Huang J, He X. Intermediate myasthenia syndrome following acute organophosphates poisoning-an analysis of 21 cases. Hum Exp Toxicol 1998
  9. 17(1): 40-5. 9-Perayre Bedia M, Leiva Badose E, Pasto Cardona L, Jodar Massanes R. Intermediate syndrome after organophosphate poisoning despite continuous infusion of pralidoxime. An Med Interna 2007
  10. 24(3):129-31. 10-Wananukul W, Kiateboonsri S, Thithapandra A. The ''intermediate sydrome'' as critical sequelae of organophosphate poisoning: the first report of two cases in Thailand. J Med Assoc Thai 2005
  11. 88(9): 1308-13. 11-Mattingly JE, Sullivan JE, Spiller HA, Bosse GM. Intermediate syndrome after exposure to chlorpyrifos in a 16-month-old girl. J Emerg Med 2003
  12. 25(4): 379-81. 12-Bentur Y, Raikhlin-Eisenkraft B, Singer P. Beneficial late administration of obidoxime in malathion poisoning. Vet Hum Toxicol 2003
  13. 45(1):33-5. 13-Guadarrama-Naveda M, de Cabrera LC, MatosBastidas S. Intermediate syndrome secondary to ingestion of chlorpyrifos. Vet Hum Toxicol 2001
  14. 43(1): 34. 14-Lee F, Lin JL. Intermediate syndrome after organophosphate intoxication in patient with end-stage renal disease. Ren Fail 2006
  15. 28(2):197-200. 15-Karalliedde L, Baker D, Marrs TC. Organophosphateinduced intermediate syndrome: aetiology and relationships with myopathy. Toxicol Rev 2006
  16. 25(1):1- 14. 16-Eyer P. Neuropyschopatholojical changes by organophosphorus compounds: a review. Hum Exp Toxicol 1995