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Different clinical features of amitraz poisoning in children
M Emre Atabek1, K Aydin, I Erkul
1Department of Pediatrics, Faculty of Medicine, Selçuk University, Konya, Turkey. eatabek@selcuk.edu.tr
Insights
Amitraz poisoning in children can cause central nervous system depression and other signs within 72 hours. Severe cases may require resuscitation, with some showing reversible mydriasis and elevated liver function tests.
Area of Science:
- Toxicology
- Pediatric Emergency Medicine
- Clinical Toxicology
Background:
- Amitraz is an acaricide and insecticide used in veterinary medicine.
- Information on amitraz poisoning in children, especially via dermal exposure, is limited.
- Classical signs of alpha2-adrenergic stimulation are not well-documented in human pediatric cases.
Purpose of the Study:
- To evaluate the clinical experience of amitraz poisoning in pediatric patients.
- To present and compare clinical and laboratory features of amitraz poisoning in children.
- To highlight the manifestations and outcomes of severe amitraz poisoning in children.
Main Methods:
- Retrospective case series of 14 children with amitraz poisoning.
- Clinical and laboratory features were documented and analyzed.
- Data were compared with findings from previous studies.
Main Results:
- Clinical manifestations appeared within 30-150 minutes via oral and dermal routes.
- Central nervous system (CNS) depression was the most significant sign, resolving within 6-24 hours.
- Three severe cases experienced reversible mydriasis, required resuscitation due to cardiopulmonary arrest from respiratory depression, had elevated hepatic function tests, and two developed aspiration pneumonitis.
Conclusions:
- Dermal amitraz poisoning presents with milder symptoms compared to oral exposure, with no topical signs.
- Classical alpha2-adrenergic stimulation signs like bradycardia and mydriasis were observed in severe pediatric cases, contrasting with prior reports.
- Amitraz poisoning in children can lead to severe outcomes, including respiratory depression and cardiopulmonary arrest, necessitating prompt medical intervention.
Objective:
To evaluate clinical experience of amitraz poisoning in children.
Methods:
In this study, the clinical and laboratory features of amitraz poisoning in 14 children are presented and compared with previous studies.
Results:
This study revealed that clinical manifestations of poisoning by oral and dermal routes appeared within 30-150 min, and that central nervous system (CNS) depression, which is the most important sign, improved within 6-24 hours and other signs within 24-72 hours. Unlike the findings in other studies, three severe cases in our study had reversible mydriasis and one of them required resuscitation because of cardiopulmonary arrest occurring as a result of serious respiratory depression. In addition, hepatic function test levels had increased in these three cases, and aspiration pneumonitis existed because of emesis in two of them.
Conclusion:
There is little information in the literature about dermal poisoning. The signs and symptoms of dermal poisoning were relatively mild compared with oral poisoning, and there were no topical signs. The classical signs of alpha2-adrenergic stimulation such as marked sinusal bradycardia and mydriasis as reported in many poisoning cases of animals have not been reported before our three severe cases among children.