- Elevation of Procalcitonin in an Adolescent Acetaminophen Intoxication
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So Eun Kim, Jae Baek Lee, Young Ho Jin, Jae Chol Yoon, Si On Jo, Tae Oh Jeong
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J Korean Soc Clin Toxicol. 2019;17(1):38-41. Published online June 30, 2019
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DOI: https://doi.org/10.22537/jksct.2019.17.1.38
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- Procalcitonin (PCT) is commonly employed in medical practice as a diagnostic biomarker of bacterial infection and also as a monitoring biomarker for antimicrobial therapy. There have been a few published reports concerning elevated PCT levels in people with acute liver injury caused by an overdose of acetaminophen. We report here on a case of PCT elevation in an adolescent with acute acetaminophen poisoning without any bacterial infection or liver injury. A 15-year-old girl had deliberately ingested 20 tablets of 650 mg acetaminophen (13 g) and she presented to our emergency department. The PCT level on admission was elevated to 65.64 ng/mL (reference range: 0-0.5 ng/mL). Her PCT level on the second day peaked up to 100 ng/mL and then it gradually decreased. There was no evidence of liver injury or infection on the computed tomography examination and other lab tests. The patient regained her good health and was discharged on the sixth day of hospitalization.
- Symptomatic Hypocalcemia Associated with Dioscorea tokoro Toxicity
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Jae Chol Yoon, Jae Baek Lee, Tae Oh Jeong, Si On Jo, Young Ho Jin
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J Korean Soc Clin Toxicol. 2019;17(1):42-45. Published online June 30, 2019
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DOI: https://doi.org/10.22537/jksct.2019.17.1.42
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- Dioscorea tokoro has long been used in Korean traditional medicine as a pain killer and anti-inflammatory agent. A 53-year-old male who consumed water that had been boiled with raw tubers of D. tokoro as tea presented with numbness and spasm of both hands and feet. Laboratory results showed hypocalcemia, hypoparathyroidism, and vitamin D insufficiency. During his hospital stay, colitis, acute kidney injury, and toxic encephalopathy developed. The patient received calcium gluconate intravenous infusion and oral calcium carbonate with alfacalcidol. His symptoms improved gradually, but hypocalcemia persisted despite the calcium supplementation. We suggest that ingestion of inappropriately prepared D. tokoro can cause symptomatic hypocalcemia in patients with unbalanced calcium homeostasis.
- Two Cases of Neurotoxin Tetramine Poisoning Following Ingestion of Buccinum Striatissinum
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So Eun Kim, Jae Baek Lee, Young Ho Jin, Jae Chol Yoon, Si On Jo, Jeong Moon Lee, Tae Oh Jeong
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J Korean Soc Clin Toxicol. 2016;14(1):66-69. Published online June 30, 2016
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- Some carnivorous gastropods have heat stable tetramine toxins in their salivary glands. This toxin is an autonomic ganglionic blocking agent that enables them to catch the prey easily by paralyzing their targets. Acute tetramine toxin poisoning in humans from eating whelks has been well described based on numerous cases, but is rare in Korea. Symptoms of tetramine poisoning include eyeball pain, blurred vision, headache, dizziness, muscular twitching, tingling of hands and feet, weakness, paralysis and sometimes collapse. Gastrointestinal symptoms, such as abdominal pain, nausea, and vomiting can also occur. However, intoxication is self-limiting and patients will usually recover in about 24 hours. Herein, we report 2 cases of tetramine poisoning after ingestion of Buccinum striatissinum as meat and soup.
- Clinical Analysis of Acute Endosulfan Poisoning: Single Center Experience
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So Eun Kim, Su Ik Kim, Jae Baek Lee, Young Ho Jin, Tae Oh Jeong, Si On Jo, Jae Chol Yoon
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J Korean Soc Clin Toxicol. 2015;13(2):71-77. Published online December 31, 2015
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- Purpose: Acute endosulfan poisoning is rare but causes significant morbidity and mortality. The aim of our study is to describe complications and features of seizure and determine factors associated with mortality in acute endosulfan poisoning. Methods: Twenty-eight adult patients with acute endosulfan poisoning admitted to our emergency department during a 15-year period were studied retrospectively. The clinical features of seizure, use of antiepileptic drugs during seizure, and hospital courses were evaluated. Clinical factors between survived group and non-survived group were compared for identification of factors associated with mortality. Results: Of the 28 patients with endosulfan poisoning, 4 patients (14.3%) died and 15 (53.6%) patients developed generalized tonic-clonic seizure. Thirteen patients (46.4%) and 5 patients (17.9%) progressed to status epilepticus (SE) and refractory status epilepticus (RSE), respectively. SE and RSE were associated with mortality. Almost all significant complications including shock, acute renal failure, hepatic toxicity, rhabdomyolysis, and cardiac injury developed in SE and RSE patients. Conclusion: SE and RSE were important contributors to death in endosulfan poisoning. Emergency physicians treating endosulfan poisoning should make an effort not to progress seizure following endosulfan poisoning to SE and RSE using a rapid and aggressive antiepileptic drug.
- Measurement of Volume of a Swallow for Liquid Swallowing in Healthy Young Adults
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Su Ik Kim, Ji Hun Kang, Dong Ik Lee, Jeong Ryul Jo, Hyung Jun Kim, Jae Baek Lee, Young Ho Jin, Tae Oh Jeong, Jae Chol Yoon
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J Korean Soc Clin Toxicol. 2013;11(2):114-118. Published online December 31, 2013
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- Purpose: The aim of this study is to estimate one mouthful volume in a single swallow and average volume per swallow (AVS) in multiple swallows in the situation of toxic liquid poisoning. Methods: Thirty five men and 35 women were included in this study. Each subject was asked to drink one swallow and three consecutive swallows from bottle containing water and a bottle containing saline separately. We calculated one mouthful volume in a single swallow and AVS in three swallows. One mouthful volume and AVS were compared according to sex and content, respectively. One mouthful volume of water and saline was then compared with AVS of each. Results: Sixty seven adults(34 men; $26.9{pm}3.2$ years, 33 women; $25.6{pm}2.4$ years) completed the study. Men had larger one mouthful volume of water($49.1{pm}19.9$ ml vs $39.7{pm}10.2$ ml, p=0.02) and saline($20.7{pm}10.9$ ml vs $14.0{pm}4.6$ ml, p=0.004) and AVS of water($28.5{pm}11.9$ ml vs $21.5{pm}5.9$ ml, p=0.004) and saline($11.9{pm}6.3$ ml vs $7.9{pm}2.0$ ml, p=0.001) than women. One mouthful volume and AVS of saline swallow were lower than those of water swallow. AVS of three consecutive swallows was lower than one mouthful volume in water and saline swallow. Conclusion: We suggest that one mouthful volume in a single swallow is 21 ml in men and 14 ml in women and AVS in multiple swallows is 12 ml in men and 8 ml in women. AVS in multiple swallows is two-threefold lower than reference values(20~30 ml) commonly used in poisoning study.
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KSCT
Korean Society of Clinical Toxicology