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A life-threatening dichlorophen poisoning case: clinical features and kinetics study.
J Langrand1, C Moesch, R Le Grand
1Medical and Toxicological Critical Care Department, Lariboisière Hospital, Paris-Diderot University, Paris, France.
Clinical Toxicology (Philadelphia, Pa.)
|March 12, 2013
Summary
Human dichlorophen poisoning is rare but can cause severe multiorgan failure. This case demonstrates that complete recovery is possible with prompt supportive management for dichlorophen poisoning.
Area of Science:
- Toxicology
- Clinical Chemistry
Background:
- Human dichlorophen poisoning is infrequently reported.
- This study details a rare case of severe dichlorophen poisoning with multiorgan failure.
Observation:
- A 74-year-old female ingested a concentrated dichlorophen solution.
- She developed caustic gastrointestinal injuries, confusion, diarrhea, electrolyte imbalances, acute kidney injury, and elevated liver enzymes.
- Serum dichlorophen levels were significantly high (708.1 μg/L) with a prolonged elimination half-life (35.5 h).
Findings:
- Dichlorophen poisoning can lead to rapid-onset caustic digestive lesions, liver enzyme disturbances, acute kidney injury, and rhabdomyolysis.
- Serum dichlorophen concentrations were measured using liquid chromatography-heated electrospray ionization-tandem mass spectrometry (LC-HESI-MS/MS).
- Despite initial life-threatening symptoms, the patient experienced a favorable outcome with supportive care.
Implications:
- Prompt and comprehensive supportive management is crucial for patients with severe dichlorophen poisoning.
- This case highlights the potential for complete recovery even in cases of extreme toxicity and multiorgan dysfunction.
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