Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
권호 표지
DOI QR코드

DOI QR Code

A Case Report of Acute Nicotine Poisoning from Subcutaneous Injection of Nicotine Solution for Electronic Cigarette

전자담배 용액의 피하 주사에 의한 급성 니코틴 중독 1례

  • Choi, Jiun (Department of Emergency Medicine, Yonsei University College of Medicine) ;
  • Ko, Dong Ryul (Department of Emergency Medicine, Yonsei University College of Medicine) ;
  • You, Je Sung (Department of Emergency Medicine, Yonsei University College of Medicine) ;
  • Chung, Sung Phil (Department of Emergency Medicine, Yonsei University College of Medicine)
  • 최지운 (연세대학교 의과대학 응급의학교실) ;
  • 고동률 (연세대학교 의과대학 응급의학교실) ;
  • 유제성 (연세대학교 의과대학 응급의학교실) ;
  • 정성필 (연세대학교 의과대학 응급의학교실)
  • Received : 2016.11.22
  • Accepted : 2017.01.23
  • Published : 2017.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Nicotine-poisoning related to the electronic cigarettes (e-cigarette) is increasing worldwide. Moreover, the American Association of Poison Control Centers has advised the public to use caution with e-cigarette devices and highly concentrated liquid nicotine after a surge in related poisonings. We report here the first case of nicotine poisoning from self-injected e-cigarette fluid in Korea. A 17-year-old male patient subcutaneously injected himself with 0.5 ml of nicotine solution for an electronic cigarette via the dorsum of his hand, after which he complained of nausea, vomiting, dizziness and dyspnea. His vital signs were within the normal range, but his mental status was drowsy. He was admitted for observation and the symptoms disappeared the following day. Sinus bradycardia with a rate of 45/min was observed on the third hospital day, but improved after 6 hours. He was discharged without complications.

Keywords

References

  1. Hua M, Talbot P. Potential health effects of electronic cigarettes: A systematic review of case reports. Prev Med Rep 2016;4:169-78. https://doi.org/10.1016/j.pmedr.2016.06.002
  2. Cooke A, Fergeson J, Bulkhi A, Casale TB. The Electronic Cigarette: The Good, the Bad, and the Ugly. J Allergy Clin Immunol Pract 2015;3(4):498-505. https://doi.org/10.1016/j.jaip.2015.05.022
  3. Lee S, Kimm H, Yun JE, Jee SH. Public health challenges of electronic cigarettes in South Korea. J Prev Med Public Health 2011;44(6):235-41. https://doi.org/10.3961/jpmph.2011.44.6.235
  4. Breland A, Soule E, Lopez A, Ramoa C, El-Hellani A, Eissenberg T. Electronic cigarettes: what are they and what do they do? Ann NY Acad Sci 2016:1-26.
  5. Miller A. Nicotine poisoning increase due to e-cigarettes. CMAJ 2014:186(10):e367. https://doi.org/10.1503/cmaj.109-4818
  6. Jun YJ, Kim HJ, Park SH. Suicidal death by nicotine poisoning. Korean J Leg Med 2014;38:167-70. https://doi.org/10.7580/kjlm.2014.38.4.167
  7. Soghoian S. Nicotine. In: Hoffman RS, Howland MA, Lewin N, Nelson LS, Goldfrank LR, editors. Goldfrank's Toxicologic Emergencies. 10th ed. New York; McGraw Hill; 2015. p1138-43.
  8. Sommerfeld K, Lukasik-Glebocka M, Kulza M, Druzdz A, Panienski P, Florek E et al. Intravenous and oral suicidal e-liquid poisonings with confirmed nicotine and cotinine concentrations. Forensic Sci Int 2016:e15-e20.
  9. Ordonez JE, Kleinschmidt KC, Forrester MB. Electronic cigarette exposures reported to Texas poison centers. Nicotine Tob Res 2015;17(2):209-11. https://doi.org/10.1093/ntr/ntu223
  10. Chen BC, Bright SB, Trivedi AR, Valento M. Death following intentional ingestion of e-liquid. Clin Toxicol (Phila) 2015;53(9):914-6. https://doi.org/10.3109/15563650.2015.1090579
  11. Bartschat S, Mercer-Chamlmers-Bender K Beike J, Rothschild MA, Jubner M. Not only smoking is deadly: fatal ingestion of e-juice-a case report. Int J Legal Med 2015;129(3):481-6. https://doi.org/10.1007/s00414-014-1086-x
  12. Gupta S, Gandhi A, Manikonda R. Accidental nicotine liquid ingestion: emerging paediatric problem. Arch Dis Child 2014;99(12):1149. https://doi.org/10.1136/archdischild-2014-306750
  13. Schipper EM, de Graaff LC, Koch BC, Brkic Z, Wilms EB, Alsma J, Schuit SC. A new challenge: suicide attempt using nicotine filling for electronic cigarettes. Br J Clin Pharmacol 2014;78(6):1469-71. https://doi.org/10.1111/bcp.12495
  14. Eberlein CK, Frieling H, Kohnlein T, Hillemacher T, Bleich S. Suicide attempt by poisoning using nicotine liquid for use in electronic cigarettes. Am J Psychiatry 2014; 171(8):891. https://doi.org/10.1176/appi.ajp.2014.14030277
  15. Bassett RA, Osterhoudt K, Brabazon T. Nicotine poisoning in an infant. N Engl J Med 2014;370(23):2249-50. https://doi.org/10.1056/NEJMc1403843
  16. Thornton SL, Oller L, Sawyer T. Fatal Intravenous injection of electronic nicotine delivery system refilling solution. J Med Toxicol 2014;10:202-4. https://doi.org/10.1007/s13181-014-0380-9
  17. Gill N, Sangha G, Poonai N, Lim R. E-cigarette liquid nicotine ingestion in a child: Case report and discussion. CJEM 2015;17(6):699-703. https://doi.org/10.1017/cem.2015.10
  18. Morris DS, Fiala SC. Online electronic cigarette retailers can do more to prevent accidental poisonings. Tob Control 2015;24(4):415-6. https://doi.org/10.1136/tobaccocontrol-2014-051779

Cited by

  1. 액상형 전자담배 용액에 의한 급성 니코틴 중독: 증례보고의 체계적 고찰 vol.18, pp.2, 2017, https://doi.org/10.22537/jksct.2020.18.2.51