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Tetramine poisoning.

C M Chau1, A K H Leung, I K S Tan

  • 1Intensive Care Unit, North District Hospital, Sheung Shui, Hong Kong. chinman2@netvigator.com

Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi
|December 13, 2005
PubMed
Summary

Two patients experienced severe seizures from tetramine rat poison. Ketamine controlled seizures, and hemoperfusion successfully removed the toxin, lowering plasma levels.

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Area of Science:

  • Toxicology
  • Neurology
  • Nephrology

Background:

  • Tetramine is a toxic alkaloid found in some rat poisons.
  • Status epilepticus is a neurological emergency characterized by prolonged seizures.

Observation:

  • Two patients presented with status epilepticus after ingesting a meal suspected to contain tetramine.
  • Initial physical examinations and investigations were unremarkable.
  • Seizures were refractory to benzodiazepines and sodium thiopentone.

Findings:

  • Ketamine was effective in controlling the seizures.
  • High-volume hemofiltration followed by charcoal hemoperfusion significantly reduced plasma tetramine levels.
  • Plasma tetramine decreased from 0.95 to 0.35 microgram/mL and 0.53 to 0.40 microgram/mL in the two patients.

Implications:

  • This case highlights ketamine as a potential treatment for tetramine-induced seizures.
  • Hemoperfusion is an effective modality for rapid toxin elimination.
  • Prompt diagnosis based on history is crucial for managing tetramine poisoning.

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