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http://dx.doi.org/10.22537/jksct.2021.19.1.59

Use of succimer as an alternative antidote in copper sulfate poisoning: A case report  

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)
Publication Information
Journal of The Korean Society of Clinical Toxicology / v.19, no.1, 2021 , pp. 59-63 More about this Journal
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
Copper sulfate; Hemolysis; Acute kidney injury; Succimer;
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