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她情绪低落:一例罕见的硫酸铜中毒病例。

She Has The Blues: An Unusual Case of Copper Sulphate Intoxication.

作者信息

Moussiegt Aurore, Ferreira Luis, Aboab Jérôme, Silva Daniel

机构信息

Service de Réanimation, Hôpital Delafontaine, Saint Denis, France.

出版信息

Eur J Case Rep Intern Med. 2020 Jan 21;7(2):001394. doi: 10.12890/2020_001394. eCollection 2020.

DOI:10.12890/2020_001394
PMID:32133310
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7050968/
Abstract

BACKGROUND

Copper is an essential trace element of the human body. However, it is related to many diseases. Copper intoxication is not common in Western countries, but needs to be rapidly recognised because of its high lethality.

CASE PRESENTATION

We report the case of a 40-year-old woman who presented to the emergency department after performing intrarectal administration of a blue powder sent from Cameroon by her family, in the belief that this would help her to get pregnant. Her evolution was complicated by multiorgan failure and the unusual circumstances. The diagnosis was suspected on the basis of the clinical presentation and the colour of the powder, and confirmed by blood dosage and toxicological analysis of the powder. She underwent symptomatic treatment, and the outcome was progressively favourable, apart from persistent chronic renal failure with dependence on dialysis.

CONCLUSION

Copper intoxications are rare but severe. Laboratory diagnosis of the condition is not an issue; the difficulty is suspecting it and quickly initiating chelation treatment associated with symptomatic treatments.

LEARNING POINTS

Copper sulphate is a rare but severe condition that must be promptly diagnosed. Diagnosis may be based on clinical presentation, characterised by multiple organ failure, and suspected in the case of ingestion of a blue chemical product.In the presence of saturation gap on pulse oximetry, the clinician must consider the possibility of methemoglobinaemia, and look for toxic causes.Treatment of copper sulphate poisoning requires mainly symptomatic treatment and chelation of copper by oral or IV drugs.

摘要

背景

铜是人体必需的微量元素。然而,它与许多疾病有关。铜中毒在西方国家并不常见,但因其高致死率而需要迅速识别。

病例报告

我们报告一例40岁女性病例,她在经直肠使用了家人从喀麦隆寄来的蓝色粉末后被送往急诊科,家人认为这会帮助她怀孕。她的病情因多器官功能衰竭和特殊情况而复杂化。根据临床表现和粉末颜色怀疑诊断,并通过血液检测和粉末的毒理学分析得以确诊。她接受了对症治疗,除了依赖透析的持续性慢性肾衰竭外,病情逐渐好转。

结论

铜中毒罕见但严重。该病的实验室诊断并非问题;困难在于怀疑该病并迅速启动与对症治疗相关的螯合治疗。

经验教训

硫酸铜中毒是一种罕见但严重的疾病,必须迅速诊断。诊断可基于以多器官功能衰竭为特征的临床表现,在摄入蓝色化学产品的情况下应怀疑该病。在脉搏血氧饱和度仪出现饱和差时,临床医生必须考虑高铁血红蛋白血症的可能性,并寻找中毒原因。硫酸铜中毒的治疗主要需要对症治疗以及通过口服或静脉用药螯合铜。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d7a/7050968/32bba3db16d9/1394_Fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d7a/7050968/c23c350cb27e/1394_Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d7a/7050968/ce858b46bee6/1394_Fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d7a/7050968/32bba3db16d9/1394_Fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d7a/7050968/c23c350cb27e/1394_Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d7a/7050968/ce858b46bee6/1394_Fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d7a/7050968/32bba3db16d9/1394_Fig3.jpg

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Acute copper sulfate poisoning resulting from dermal absorption.经皮肤吸收导致的急性硫酸铜中毒。
Am J Ind Med. 2018 Jul 27. doi: 10.1002/ajim.22892.
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Blue vitriol poisoning: a 10-year experience in a tertiary care hospital.硫酸亚铁中毒:一家三级医院的 10 年经验。
Clin Toxicol (Phila). 2012 Mar;50(3):197-201. doi: 10.3109/15563650.2012.660572.
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Acute copper sulphate poisoning: a forgotten cause of severe intravascular haemolysis.急性硫酸铜中毒:严重血管内溶血的一个被遗忘的病因。
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