Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
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Use of succimer as an alternative antidote in copper sulfate poisoning: A case report

황산구리 중독에서 대안 해독제로의 succimer 사용 1례

  • Han, Sang Kyoon (Department of Emergency Medicine, Pusan National University Hospital) ;
  • Park, Sung Wook (Department of Emergency Medicine, Pusan National University Hospital) ;
  • Cho, Young Mo (Department of Emergency Medicine, Pusan National University Hospital) ;
  • Wang, Il Jae (Department of Emergency Medicine, Pusan National University Hospital) ;
  • Bae, Byung Kwan (Department of Emergency Medicine, Pusan National University Hospital) ;
  • Yeom, Seok Ran (Department of Emergency Medicine, Pusan National University Hospital) ;
  • Park, Soon Chang (Department of Emergency Medicine, Pusan National University Hospital)
  • 한상균 (부산대학교병원 응급의학과) ;
  • 박성욱 (부산대학교병원 응급의학과) ;
  • 조영모 (부산대학교병원 응급의학과) ;
  • 왕일재 (부산대학교병원 응급의학과) ;
  • 배병관 (부산대학교병원 응급의학과) ;
  • 염석란 (부산대학교병원 응급의학과) ;
  • 박순창 (부산대학교병원 응급의학과)
  • Received : 2020.11.13
  • Accepted : 2020.12.09
  • Published : 2021.06.30
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Abstract

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.

Keywords

Acknowledgement

This work was supported by 2020 research grant from Pusan national university hospital.

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