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Human pesticide poisonings by a fat-soluble organophosphate insecticide
Abstract:
In five cases of dichlofenthion poisoning due to suicidal ingestions, unusual toxicologic features were encountered. Initial symptoms were mild or delayed and severe cholinergic crises did not appear until 40 to 48 hours after ingestion. Two patients died, and in the three survivors, cholinesterase symptoms persisted for five to 48 days. An almost total inhibiton of both cholinesterase enzymes continued in one patient for 66 days, and prolonged antidotal therapy was required. Residues of the intact pesticide were detected in fat after 54 days in one patient, and in the blood for 75 days in another patient. The partition coefficient of dichlofenthion in fat was 20 times greater than parathion, and exceeded only by leptophos. Considering the chemical and toxicologic properties of this compound, we postulated that the mechanism of protracted intoxication is a slow release from adipose reservoirs.
Insights
Dichlofenthion poisoning presents delayed, prolonged symptoms due to slow release from fat stores. This organophosphate pesticide requires extended treatment and monitoring for severe toxicity.
Area of Science:
- Toxicology
- Environmental Health
- Pharmacology
Background:
- Organophosphate pesticides like dichlofenthion are widely used but can cause severe poisoning.
- Understanding the toxicokinetics and toxicodynamics of specific pesticides is crucial for effective treatment.
Observation:
- Five cases of dichlofenthion poisoning exhibited delayed onset of severe cholinergic crisis (40-48 hours post-ingestion).
- Profound cholinesterase inhibition persisted for weeks (up to 66 days), necessitating prolonged antidotal therapy.
- Intact dichlofenthion residues were detectable in blood and fat tissue long after exposure (up to 75 days).
Findings:
- Dichlofenthion demonstrates a high lipophilicity, with a partition coefficient in fat 20 times greater than parathion.
- The slow release of dichlofenthion from adipose tissue reservoirs is postulated as the mechanism for protracted intoxication.
- This prolonged toxicity profile distinguishes dichlofenthion from other commonly encountered organophosphates.
Implications:
- Clinical management of dichlofenthion poisoning requires awareness of its delayed and prolonged toxic effects.
- Extended monitoring for cholinesterase activity and potential relapse is essential.
- The findings highlight the need for further research into the long-term toxicological effects of lipophilic pesticides and their management strategies.