Paul Rudrajit, Talukdar Arunansu, Bhattacharya Raja, Santra Gouranga
Department of General Medicine, Medical College Kolkata, Kolkata, West Bengal, India.
BMJ Case Rep. 2013 Aug 7;2013:bcr2013009851. doi: 10.1136/bcr-2013-009851.
γ-Benzene hexachloride is a commonly used insecticide of organochlorine group. Notable toxic effects include seizures, ataxia, confusion and other central nervous system dysfunction. A 30-year-old male farmer with suicidal ingestion of γ-benzene hexachloride poison developed acute intrinsic renal failure with azotaemia and diminished urine output along with features of acute fulminate liver failure. Renal function recovered with haemodialysis and liver parameters gradually normalised with time. As per our knowledge simultaneous acute hepatic and kidney injury associated with γ-benzene hexachloride poison is never reported in humans. The exact pathophysiology of this life-threatening complication is an enigma. However, oxidative stress has been postulated as a contributory factor as suggested in animal studies. Conservative management with successful outcome in our case stresses on the impact of watchful observation and aggressive management. He was discharged after 3 weeks at stable condition and was healthy at 3 months follow-up.
γ-六氯环己烷是一种常用的有机氯类杀虫剂。显著的毒性作用包括癫痫发作、共济失调、意识模糊和其他中枢神经系统功能障碍。一名30岁的男性农民因自杀性摄入γ-六氯环己烷中毒，出现了急性肾实质衰竭伴氮质血症、尿量减少以及急性暴发性肝衰竭的症状。肾功能通过血液透析得以恢复，肝脏参数随时间逐渐恢复正常。据我们所知，人类中从未有过与γ-六氯环己烷中毒相关的同时性急性肝损伤和肾损伤的报道。这种危及生命的并发症的确切病理生理学仍是一个谜。然而，正如动物研究中所提示的，氧化应激被认为是一个促成因素。我们病例中保守治疗取得成功的结果强调了密切观察和积极治疗的影响。他在病情稳定3周后出院，3个月随访时身体健康。
