Journal of The Korean Society of Clinical Toxicology

Clinical Characteristics of Acute Dichlorvos Poisoning in Korea: Mi-Jin Lee, Joon-Seok Park, Woon-Yong Kwon, Eun-Kyung Eo, Bum-Jin Oh, Sung-Woo Lee, Joo-Hyun Suh, Hyung-Keun Roh; J Korean Soc Clin Toxicol. 2008;6(1):9-15. Published online June 30, 2008

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Abstract PDF: Purpose: Dichlorvos has been in widespread use as an organophosphate (OP) insecticide compound. The purpose of this study was to access the epidemiology and clinical features of dichlorvos in Korea. Methods: This was a 38 multi-center prospective study of dichlorvos poisoning using surveys, a structural reporting system and review of hospital records from August 2005 to July 2006. A total of 54 patients with acute dichlorvos poisoning on a national basis were enrolled. We analyzed the epidemiologic characteristics and clinical manifestations of dichlorvos poisoning. In addition, the clinical features of dichlorvos poisoning were compared with others OP compounds. Results: During the study period, compounds involving pure OP poisoning were dichlorvos (22.7%), methidathion (8.4%), and phosphamidon (6.7%). In acute dichlorvos poisoning, all ingestion routes were oral. Intentional poisoning involved 74.1% of cases. The common initial complaints involved gastrointestinal (64.8%), systemic (61.1%), central or peripheral nervous system (53.7%), and respiratory symptoms (50.0%). The median arrival time to hospital after dichlorvos poisoning was 2.6 hours and mean hospitalization duration was 7.1 days. 2-PAM was administered in 35 patients in mean doses of 6.3 g/day intravenously. Atropine was administered in 30 patients with a mean dose of 62.8 mg/day (maximal 240 mg/day). Overall mortality rate for dichlorvos poisonings were 14.8% (8/54). Immediate causes for death included sudden cardiac arrest or ventricular dysrhythmias (50%), multi-organ failure (25%), acute renal failure (12.5%), and unknown causes (12.5%). Conclusion: When compared to previous reports, dichlorvos poisoning displayed relatively moderate severity. The presence of a lower GCS score, altered mental status, serious dysrhythmias, systemic shock, acute renal failure, and respiratory complications upon presentation were associated with a more serious and fatal poisoning.

Ingestion of Hydrofluoric acid: A rapid and fetal poisoning: Jae-Hee Lee, Jin-Hee Jung, Eun-Kyung Eo; J Korean Soc Clin Toxicol. 2007;5(2):135-137. Published online December 31, 2007

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Abstract PDF: Hydrofluoric acid is a weak inorganic acid used for etching and as rust removals. Systemic toxicity after oral ingestion induces rapid development of hypocalcemia and hyperkalemia, leading to ventricular fibrillation and finally asystole. We report a case of intentional ingestion of hydrofluoric acid producing an altered mental state at the time of the patient's arrival in the emergency department. The patient died approximately 80 minutes after the exposure with asystol.

A Case of Phenypropanolamine Induced Myocardial Injury: Jong Woo Park, Min Hong Choa, Joon Seok Park, Kwang Hyun Cho; J Korean Soc Clin Toxicol. 2003;1(1):43-46. Published online June 30, 2003

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Abstract PDF: Phenypropanolamine (PPA) is a sympathetic amine used in over-the-counter cold remedies and weight-control preparations. The side effects are hypertension, dysrhythmias, stroke, etc. The Food and Drug Administration (FDA) is taking steps to remove PPA from all drug products and has requested that all drug companies discontinue marketing products containg PPA due to high risk of hemorrhage stroke. But, in Korea now, patinets take products containg PPA with over the counter. We report here the case of PPA induced myocardial injury in a young woman who takes overdose for suicide.

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