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High anion gap refractory metabolic acidosis as a critical presentation of endosulfan poisoning

Organochloride insecticides are chlorinated cyclic hydrocarbons. One of such insecticides is endosulfan (6,7,8,9,10-10 hexachloro 1,5,5a,6,9,9a-hexahydro-6-methano-2,4,3-hexadithioxanthiep in 3-oxide) and it has been widely used in agriculture since 1960. The uncontrolled use of these compounds in d...

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Autores principales: Sharma, Raj Kumar, Kaul, Anupama, Gupta, Anurag, Bhadauria, Dharmendra, Prasad, Narayan, Jain, Apoorva, Gurjar, M., Rao, Bhaskar P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3153717/
https://www.ncbi.nlm.nih.gov/pubmed/21845009
http://dx.doi.org/10.4103/0253-7613.83126
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author Sharma, Raj Kumar
Kaul, Anupama
Gupta, Anurag
Bhadauria, Dharmendra
Prasad, Narayan
Jain, Apoorva
Gurjar, M.
Rao, Bhaskar P.
author_facet Sharma, Raj Kumar
Kaul, Anupama
Gupta, Anurag
Bhadauria, Dharmendra
Prasad, Narayan
Jain, Apoorva
Gurjar, M.
Rao, Bhaskar P.
author_sort Sharma, Raj Kumar
collection PubMed
description Organochloride insecticides are chlorinated cyclic hydrocarbons. One of such insecticides is endosulfan (6,7,8,9,10-10 hexachloro 1,5,5a,6,9,9a-hexahydro-6-methano-2,4,3-hexadithioxanthiep in 3-oxide) and it has been widely used in agriculture since 1960. The uncontrolled use of these compounds in developing countries has resulted in the deaths of animals and humans. Characteristic clinical signs following acute exposure are indicative of CNS disturbances or overstimulation. Mortality and morbidity rates are high and there is no specific antidote. We present an uncommon presentation of endosulfan poisoning in a 32-year-old male with high anion gap severe refractory metabolic acidosis. The patient was treated with continuous renal replacement therapy and was salvaged. Till date, there is no case report from India for endosulfan poisoning with severe metabolic acidosis and hypotension. Through this case report, we emphasize the role of continuous renal replacement therapy as a rescue therapy for endosulfan poisoning with severe refractory metabolic acidosis and hypotension, even though it is a non dialyzable poison.
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spelling pubmed-31537172011-08-15 High anion gap refractory metabolic acidosis as a critical presentation of endosulfan poisoning Sharma, Raj Kumar Kaul, Anupama Gupta, Anurag Bhadauria, Dharmendra Prasad, Narayan Jain, Apoorva Gurjar, M. Rao, Bhaskar P. Indian J Pharmacol Drug Watch Organochloride insecticides are chlorinated cyclic hydrocarbons. One of such insecticides is endosulfan (6,7,8,9,10-10 hexachloro 1,5,5a,6,9,9a-hexahydro-6-methano-2,4,3-hexadithioxanthiep in 3-oxide) and it has been widely used in agriculture since 1960. The uncontrolled use of these compounds in developing countries has resulted in the deaths of animals and humans. Characteristic clinical signs following acute exposure are indicative of CNS disturbances or overstimulation. Mortality and morbidity rates are high and there is no specific antidote. We present an uncommon presentation of endosulfan poisoning in a 32-year-old male with high anion gap severe refractory metabolic acidosis. The patient was treated with continuous renal replacement therapy and was salvaged. Till date, there is no case report from India for endosulfan poisoning with severe metabolic acidosis and hypotension. Through this case report, we emphasize the role of continuous renal replacement therapy as a rescue therapy for endosulfan poisoning with severe refractory metabolic acidosis and hypotension, even though it is a non dialyzable poison. Medknow Publications 2011 /pmc/articles/PMC3153717/ /pubmed/21845009 http://dx.doi.org/10.4103/0253-7613.83126 Text en © Indian Journal of Pharmacology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Drug Watch
Sharma, Raj Kumar
Kaul, Anupama
Gupta, Anurag
Bhadauria, Dharmendra
Prasad, Narayan
Jain, Apoorva
Gurjar, M.
Rao, Bhaskar P.
High anion gap refractory metabolic acidosis as a critical presentation of endosulfan poisoning
title High anion gap refractory metabolic acidosis as a critical presentation of endosulfan poisoning
title_full High anion gap refractory metabolic acidosis as a critical presentation of endosulfan poisoning
title_fullStr High anion gap refractory metabolic acidosis as a critical presentation of endosulfan poisoning
title_full_unstemmed High anion gap refractory metabolic acidosis as a critical presentation of endosulfan poisoning
title_short High anion gap refractory metabolic acidosis as a critical presentation of endosulfan poisoning
title_sort high anion gap refractory metabolic acidosis as a critical presentation of endosulfan poisoning
topic Drug Watch
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3153717/
https://www.ncbi.nlm.nih.gov/pubmed/21845009
http://dx.doi.org/10.4103/0253-7613.83126
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