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Published on: April 28, 2020
Acute hemolysis caused by incidental trichlorfon exposure
1Division of Clinical Toxicology, Department of Medicine, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C. mlwu@vghtpe.gov.tw
Journal of the Chinese Medical Association : JCMA
|April 18, 2009
Summary
Trichlorfon, an organophosphate, can cause acute hemolysis and kidney issues, even without typical poisoning signs. This case highlights trichlorfon as a potential cause of acute hemolysis, emphasizing its toxicity beyond anticholinesterase effects.
Area of Science:
- Toxicology
- Pharmacology
- Nephrology
Background:
- Trichlorfon is an organophosphate pesticide with anticholinesterase properties.
- Organophosphate poisoning typically presents with specific neurological and physiological symptoms.
- Acute hemolysis is an uncommon manifestation of trichlorfon exposure.
Observation:
- A 54-year-old man experienced abdominal pain after applying trichlorfon to his dog.
- The patient developed severe nausea, vomiting, fever, chills, and jaundice.
- Laboratory results revealed acute hemolysis, renal impairment, and leukocytosis, but normal cholinesterase levels.
Findings:
- The patient presented with acute hemolysis and renal function impairment following percutaneous trichlorfon exposure.
- Clinical signs of acute cholinergic syndrome were absent, despite gastrointestinal symptoms.
- Blood cholinesterase activity remained within normal limits during the observation period.
Implications:
- Trichlorfon exposure can lead to acute hemolysis and renal dysfunction, independent of significant anticholinesterase effects.
- This case expands the known spectrum of trichlorfon toxicity.
- Trichlorfon should be recognized as a potential agent causing acute hemolysis in clinical toxicology.
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