Severe chlorate poisoning: Report of a case |
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Authors: | Christian Steffen Rainer Seitz |
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Institution: | (1) Pharmakologisches Institut, D-3550 Lahnberge, Marburg;(2) Zentrum für Innere Medizin, Medizinische Klinik der Universität, D-3550 Mannkopffstrasse 1, Marburg, Federal Republic of Germany |
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Abstract: | A case of severe sodium chlorate poisoning was observed within 5 h after suicidal ingestion of 150–200 g of the herbicide. Methaemoglobinaemia was the early symptom of the intoxication. Treatment with methylene blue and ascorbic acid could not prevent a massive haemolysis with disseminated intravascular coagulation. Hypercoagulation and hyperfibrinolysis could be treated successfully with exchange transfusions, heparin and fresh plasma. During the first hours, 70 mmol chlorate were excreted before complete renal failure occurred which required haemodialysis for several weeks. Clinical observations and in vitro experiments provide evidence that methylene blue is effective only in the very early stages of chlorate poisoning. Consequently, the following treatment is suggested: gastric lavage, exchange transfusion, bicarbonate infusion, haemodialysis, anticoagulation with heparin and substitution of clotting factors if necessary.Dedicated to Prof. Gustav Adolf Martini on occasion of his sixty-fifth birthdayA preliminary report has been given at the Spring Meeting of the German Pharmacological Society, Mainz, March 1981 |
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Keywords: | Sodium chlorate poisoning Methaemoglobinaemia Methylene blue Haemolysis Disseminated intravascular coagulation |
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