TY - JOUR
T1 - Severe glyphosate-surfactant intoxication
T2 - Successful treatment with continuous renal replacement therapy
AU - Lee, Dong Hoon
AU - Choi, Yoon Hee
N1 - Publisher Copyright:
© 2017, Medcom Limited. All rights reserved.
PY - 2017/1
Y1 - 2017/1
N2 - Glyphosate-surfactant is one of the most commonly used herbicides in the world. Its key component, glyphosate, is a competitive inhibitor of the shikimate pathway, a metabolic pathway found only in plants. However, severe intoxication, including lethal cases by ingestion of, glyphosate-surfactant has been reported. We describe the full recovery of two patients from glyphosate-polyoxyethyleneamine surfactant intoxication and multi-organ system failure following continuous renal replacement therapy. Both patients developed persistent shock, acute kidney injury, lactic acidosis, hyperkalaemia and multi-organ failure despite of resuscitation. We believe that continuous renal replacement therapy should be initiated immediately for removal of glyphosate-polyoxyethyleneamine surfactant in patients with signs of cardiopulmonary compromise, lactic acidosis, and renal failure. We propose the addition of glyphosate-polyoxyethyleneamine surfactant to the list of toxins for which early haemodialysis should be indicated.
AB - Glyphosate-surfactant is one of the most commonly used herbicides in the world. Its key component, glyphosate, is a competitive inhibitor of the shikimate pathway, a metabolic pathway found only in plants. However, severe intoxication, including lethal cases by ingestion of, glyphosate-surfactant has been reported. We describe the full recovery of two patients from glyphosate-polyoxyethyleneamine surfactant intoxication and multi-organ system failure following continuous renal replacement therapy. Both patients developed persistent shock, acute kidney injury, lactic acidosis, hyperkalaemia and multi-organ failure despite of resuscitation. We believe that continuous renal replacement therapy should be initiated immediately for removal of glyphosate-polyoxyethyleneamine surfactant in patients with signs of cardiopulmonary compromise, lactic acidosis, and renal failure. We propose the addition of glyphosate-polyoxyethyleneamine surfactant to the list of toxins for which early haemodialysis should be indicated.
KW - Glycine
KW - Herbicide
KW - Human
KW - Multiple organ failure
KW - Poisoning
UR - http://www.scopus.com/inward/record.url?scp=85010906079&partnerID=8YFLogxK
U2 - 10.1177/102490791702400107
DO - 10.1177/102490791702400107
M3 - Article
AN - SCOPUS:85010906079
SN - 1024-9079
VL - 24
SP - 40
EP - 44
JO - Hong Kong Journal of Emergency Medicine
JF - Hong Kong Journal of Emergency Medicine
IS - 1
ER -