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Young Mo Cho 1 Article
Use of succimer as an alternative antidote in copper sulfate poisoning: A case report
Sang Kyoon Han, Sung Wook Park, Young Mo Cho, Il Jae Wang, Byung Kwan Bae, Seok Ran Yeom, Soon Chang Park
J Korean Soc Clin Toxicol. 2021;19(1):59-63.   Published online June 30, 2021
DOI: https://doi.org/10.22537/jksct.2021.19.1.59
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Copper sulfate is widely used as a fungicide and pesticide. Acute copper sulfate poisoning is rare but potentially lethal in severe cases. Copper sulfate can lead to cellular damage of red blood cells, hepatocytes, and myocytes. Toxic effects include intravascular hemolysis, acute tubular necrosis and, rhabdomyolysis. A 76-year-old man presented with vomiting and epigastric pain. He had ingested a copper-containing fungicide (about 13.5 g of copper sulfate) while attempting suicide 2 hours prior to presentation. From day 3 at the hospital, laboratory findings suggesting intravascular hemolysis were noted with increased serum creatinine level. He was treated with a chelating agent, dimercaptosuccinic acid (succimer). His anemia and acute kidney injury gradually resolved with a 19-day regimen of succimer. Our case suggests that succimer can be used for copper sulfate poisoning when other chelating agents are not available.

JKSCT : Journal of The Korean Society of Clinical Toxicology