Jain Mukesh K, Patnaik Sibabratta, Rup Amit R, Gaurav Abhinav
Department of Pediatrics, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Indian J Crit Care Med. 2020 Jun;24(6):477-479. doi: 10.5005/jp-journals-10071-23448.
Accidental poisoning in children is very common, making up 10.9% of all unintentional injuries worldwide. Africa has the highest incidence of fatal poisonings worldwide, at 4 per 100,000. Poisoning with podophyllin is rare, with most cases documented around the 1970s to 1980s. Podophyllin is a resin mixture obtained from the dried Rhizome and roots of (North America) and (India). Podophyllotoxin is the most toxic chemical present in the podophyllin, which is lipid soluble; so crosses the cell membrane easily and inhibits mitotic spindle formation. Both topical application and oral consumption can cause podophyllin poisoning. Neurotoxicity is the most serious effect along with bone marrow depression, gastrointestinal irritation, and hepatic and renal dysfunction. Management of podophyllin toxicity is mainly symptomatic, and no specific antidote exists. We report a case of a 2-year-old-year girl with accidental podophyllin poisoning, who presented with neurotoxicity followed by multiorgan dysfunction and then succumbed. Education of parents and healthcare workers on home safety still remains the mainstay of prevention. Jain MK, Patnaik S, Rup AR, Gaurav A. A Rare Case of Podophyllin Poisoning: Early Intervention is Lifesaving. Indian J Crit Care Med 2020;24(6):477-479.
儿童意外中毒非常常见，占全球所有意外伤害的10.9%。非洲是全球致命中毒发生率最高的地区，每10万人中有4例。鬼臼毒素中毒很罕见，大多数病例记录于20世纪70年代至80年代。鬼臼毒素是从（北美）和（印度）的干燥根茎及根中获得的一种树脂混合物。鬼臼毒素是鬼臼树脂中毒性最强的化学物质，它是脂溶性的，因此很容易穿过细胞膜并抑制有丝分裂纺锤体的形成。局部应用和口服均可导致鬼臼毒素中毒。神经毒性是最严重的影响，同时伴有骨髓抑制、胃肠道刺激以及肝肾功能障碍。鬼臼毒素中毒的治疗主要是对症治疗，目前尚无特效解毒剂。我们报告一例2岁女童意外鬼臼毒素中毒病例，该患儿先是出现神经毒性，随后出现多器官功能障碍，最终死亡。对家长和医护人员进行家庭安全方面的教育仍然是预防的主要手段。Jain MK、Patnaik S、Rup AR、Gaurav A。一例罕见的鬼臼毒素中毒病例：早期干预可挽救生命。《印度重症监护医学杂志》2020年；24(6):477 - 479。
