Clinical Toxicology Unit, Princess Alexandra Hospital, Brisbane, Australia.
Faculty of Medicine, University of Queensland, Brisbane, Australia.
Clin Toxicol (Phila). 2021 Jan;59(1):61-64. doi: 10.1080/15563650.2020.1757103. Epub 2020 Apr 27.
Triclopyr is a synthetic auxin-like herbicide. It is considered to have low toxicity and there are few reports of poisoning. We report two cases of life-threatening toxicity following ingestions of 250 mL of 50 g/L triclopyr co-formulated with diethylene glycol monoethyl ether (DEGEE).
A 79-year-old male with a background of hypertension and atrial fibrillation presented two hours after ingestion with sedation, a severe high anion gap metabolic acidosis, raised osmolar gap and an aspiration pneumonitis. He was ventilated and dialysed for 10 h with resolution of the acidaemia. He was discharged home on day 33. A 66-year-old male with a past history of alcoholism and hypertension presented following a collapse. He had sedation, a severe high anion gap metabolic acidosis with a raised osmolar gap, acute kidney injury and vasodilatory shock. He was ventilated and received dialysis for 43 h. He had poor neurological recovery and died on day 10.
Ingestion of triclopyr formulations can produce life-threatening toxicity. In large poisonings of triclopyr co-formulated with DEGEE, a high anion gap metabolic acidosis appears to be due to the glycol ether solvent rather than triclopyr itself. Management should focus on good supportive care including dialysis for significant metabolic acidosis.
三氯吡氧乙酸是一种合成的类生长素除草剂。它被认为毒性较低，中毒的报道很少。我们报告了两例因摄入 250 毫升 50g/L 与二乙二醇单乙醚（DEGEE）复配的三氯吡氧乙酸而导致生命威胁性毒性的病例。
一名 79 岁男性，有高血压和心房颤动病史，在摄入后两小时出现镇静、严重的阴离子间隙代谢性酸中毒、渗透压间隙升高和吸入性肺炎。他接受了 10 小时的呼吸机和透析治疗，酸中毒得到缓解。他在第 33 天出院回家。一名 66 岁男性，有酗酒和高血压病史，在晕倒后出现。他出现镇静、严重的阴离子间隙代谢性酸中毒伴渗透压间隙升高、急性肾损伤和血管扩张性休克。他接受了 43 小时的呼吸机和透析治疗。他的神经功能恢复不佳，于第 10 天死亡。
摄入三氯吡氧乙酸制剂可产生危及生命的毒性。在大量摄入与 DEGEE 复配的三氯吡氧乙酸中毒的情况下，阴离子间隙代谢性酸中毒似乎是由于乙二醇醚溶剂而不是三氯吡氧乙酸本身引起的。治疗应侧重于良好的支持性治疗，包括对严重代谢性酸中毒进行透析。
