Department of Nephrology and Critical Care Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
Indian J Pharmacol. 2011 Jul;43(4):469-71. doi: 10.4103/0253-7613.83126.
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.
有机氯杀虫剂是氯化环状烃。其中一种杀虫剂是硫丹（6,7,8,9,10 - 六氯 - 1,5,5a,6,9,9a - 六氢 - 6 - 甲基 - 2,4,3 - 己二硫代 - 3 - 氧代噻吨），自1960年以来它已在农业中广泛使用。在发展中国家对这些化合物的无节制使用已导致动物和人类死亡。急性接触后的典型临床症状表明中枢神经系统紊乱或过度刺激。死亡率和发病率很高，且没有特效解毒剂。我们报告一例32岁男性硫丹中毒的罕见病例，该患者伴有高阴离子间隙严重难治性代谢性酸中毒。患者接受了连续性肾脏替代治疗并获救。迄今为止，印度尚无硫丹中毒伴严重代谢性酸中毒和低血压的病例报告。通过本病例报告，我们强调了连续性肾脏替代治疗作为硫丹中毒伴严重难治性代谢性酸中毒和低血压的挽救治疗方法的作用，尽管它是一种不可透析的毒物。
