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Multiple systems organ failure from organophosphate poisoning
A Betrosian1, M Balla, G Kafiri
1Intensive Care Unit, Hippokration General Hospital, Athens, Greece.
Journal of Toxicology. Clinical Toxicology
|January 1, 1995
Summary
Organophosphate poisoning from dimethoate ingestion can cause severe adult respiratory distress syndrome and acute renal failure. This case highlights the potential for multiple organ system failure and death despite intensive care.
Area of Science:
- Toxicology
- Critical Care Medicine
- Pathology
Background:
- Organophosphate compounds, like dimethoate, are widely used pesticides with known neurotoxic effects.
- Suicidal ingestion of organophosphates can lead to severe poisoning, requiring intensive care unit (ICU) admission.
- The spectrum of organophosphate toxicity includes cholinergic crisis, but systemic organ damage is also a concern.
Observation:
- A 68-year-old male presented with suicidal dimethoate ingestion, diagnosed with organophosphate poisoning.
- Initial treatment led to temporary improvement, followed by progressive deterioration.
- Hemodynamic monitoring revealed non-cardiogenic pulmonary edema, indicative of adult respiratory distress syndrome (ARDS).
- Renal function tests confirmed acute tubular necrosis (ATN).
Findings:
- The patient developed severe ARDS and ATN secondary to organophosphate poisoning.
- Despite comprehensive organ-specific support, the patient experienced multiple system organ failure.
- Autopsy findings confirmed ARDS and ATN as the primary pathological changes.
Implications:
- Organophosphate poisoning should be recognized as a potential cause of ARDS and ATN.
- This case underscores the severe systemic effects of organophosphate toxicity beyond neurotoxicity.
- Vigilant monitoring and aggressive supportive care are crucial in managing severe organophosphate poisoning to prevent fatal outcomes.