Glyphosate Poisoning with Acute Pulmonary Edema


Affiliations

  • Indira Gandhi Government Medical College, Department of Medicine, Nagpur, Maharashtra, India

Abstract

GlySH‑surfactant herbicide (GlySH), one of the most commonly used herbicides worldwide, has been considered as minimally toxic to humans. However, clinical toxicologists occasionally encounter cases of severe systemic toxicity. The US Environmental Protection Agency (EPA) states that ‘GlySH’ is of relatively low oral and acute dermal toxicity. It does not have anticholinesterase effect and no organophosphate‑like central nervous system (CNS) effects. The clinical features range from skin and throat irritation to hypotension and death. Severe GlySH‑surfactant poisoning is manifested by gastroenteritis, respiratory disturbances, altered mental status, hypotension refractory to the treatment, renal failure, and shock.[1] GlySH intoxication has a case fatality rate 3.2–29.3%. Pulmonary toxicity and renal toxicity seem to be responsible for mortality. Metabolic acidosis, abnormal chest X‑ray, arrhythmias, and elevated serum creatinine levels are useful prognostic factors for predicting GlySH mortality.[2] There is no antidote and the mainstay of treatment for systemic toxicity is decontamination and aggressive supportive therapy. We report a case of acute pulmonary edema, which is a rare but severe manifestation of oral GlySH poisoning, where patient survived with aggressive supportive therapy.

Keywords

Acute pulmonary edema, aggressive treatment, GlySH poisoning

Full Text:

References

Beswick E, Millo J. Fatal poisoning with GlySH surfactant herbicide. J Iran Chem Soc 2011;12:37‑9.

Lee CH, Shih CP, Hsu KH, Hung DZ, Lin CC. The early prognostic factors of glyphosate‑surfactant intoxication. Am J Emerg Med 2008;26:275‑81.

Adams RD, Good AM, Bateman DN. Report: Pesticide Exposure. Monitoring Using NPIS Resources April 2004‑March 2005. Google Scholar. National Poisons Information Service, Edinburgh, UK.

Mahendrakar K, Venkategowda PM, Rao SM, Mutkule DP. Glyphosate surfactant herbicide poisoning and management. Indian J Crit Care Med 2014;18:328‑30.

Seok SJ, Park JS, Hong JR, Gil HW, Yang JO, Lee EY, et al. Surfactant volume is an essential element in human toxicity in acute glyphosate herbicide intoxication. Clin Toxicol (Phila) 2011;49:892‑9.

Potrebić O, Jović‑Stosić J, Vucinić S, Tadić J, Radulac M. Acute glyphosate‑surfactant poisoning with neurological sequels and fatal outcome. Vojnosanit Pregl 2009;66:758‑62.

Chang CB, Chang CC. Refractory cardiopulmonary failure after glyphosate surfactant intoxication: A case report. J Occup Med Toxicol 2009;4:2.

Han SK, Jeong J, Yeom S, Ryu J, Park S. Use of a lipid emulsion in a patient with refractory hypotension caused by glyphosate‑surfactant herbicide. Clin Toxicol (Phila) 2010;48:566‑8.


Refbacks

  • There are currently no refbacks.