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Endosulfan poisoning with intravascular hemolysis
Shankar Ramaswamy1, Goverdhan Dutt Puri, Subramanyam Rajeev
1Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.
The Journal of Emergency Medicine
|November 3, 2007
Summary
A 26-year-old female experienced severe complications after Endosulfan poisoning, including seizures and multi-organ failure. Despite intensive care, she ultimately died, highlighting the high mortality associated with this pesticide exposure.
Area of Science:
- Toxicology
- Emergency Medicine
- Clinical Case Study
Background:
- Endosulfan is a toxic chlorinated insecticide with significant neurotoxic properties.
- Pesticide self-poisoning is a critical global health issue, particularly in agricultural regions.
Observation:
- A young female presented with status epilepticus following intentional Endosulfan ingestion.
- The patient rapidly developed refractory hypotension, intravascular hemolysis, and disseminated intravascular coagulation (DIC).
- Despite aggressive supportive care, including management of seizures and acidosis, the patient experienced cardiac arrest and death.
Findings:
- Endosulfan exposure can lead to severe central nervous system hyperstimulation and multi-organ failure.
- Clinical manifestations include seizures, coma, respiratory and cardiac failure, hemolysis, DIC, and metabolic acidosis.
- Reported toxicities extend to hepatic, renal, myocardial, and hematologic systems.
Implications:
- There is no specific antidote for Endosulfan poisoning, emphasizing the need for prompt decontamination and supportive care.
- Management strategies focus on seizure control, hemodynamic support, and respiratory assistance.
- The high mortality rate underscores the extreme danger of Endosulfan and the critical need for prevention and rapid medical intervention.
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