A Clinical Study of Acute Hydrogen Cyanamide Toxicity in the Period between 2006-2009 in the Poison Control Center, Ain Shams University

Abstract

Hydrogen cyanamide is an active ingredient of Dormex® used as a plant growth regulator. Reports of the acute toxic effects of hydrogen cyanamide are limited. The emerging problem of Dormex toxicity approximately started in Egypt since 1997 and led to many deaths. Therefore, the aim of this study was to illustrate acute toxic effects of hydrogen cyanamide. Subjects and Method: The study was carried out on hydrogen cyanamide intoxicated cases presented to the poison control center (PCC), Ain Shams University Hospitals in the period between January 2006 and December 2009. Symptoms, signs, laboratory investigations, and complications were recorded at the time of presentation. The study was conducted on 12 patients with acute Dormex toxicity in addition to 10 healthy individuals serving as control. Conclusion: Dormex is highly toxic and may cause serious poisoning with acute toxic effects on central nervous system, respiratory and cardiovascular systems, liver, kidney, and hematological system. So awareness of this complications and early aggressive treatment are recommended to reduce mortality.

Nephrotoxic effect of Hydrogen Cyanamide (Dormex) and possible protective role of N-acetyl cysteine in male albino rats

“…This increase in urea and creatinine induced by dormex comes in accordance with results of El Masry et al, (2000) . In previous clinical research on patients acutely intoxicated with dormex, evident nephrotoxicity was reported manifested by increase serum creatinine and blood urea level (Gamaluddin et al, 2012;Sharif and Fayed, 2021). Makris and Spanou, (2016) allocated that increased serum creatinine indicates renal injury and even at certain levels renal failure.…”

“…Oxidative stress is known to cause hepatic, renal, and lung damage. Central nervous system, cardiovascular system, and hemopoietic system are also apparently affected (Gamaluddin et al, 2012). Dormex also suggested causing parasympathetic over-activity.…”

“…Marked hepatotoxic effect of acute dormex exposure has been reported in many patients with noticeable elevation of liver enzymes together with affection of other liver function as PT and bilirubin level. Considerable elevation of serum creatinine has been recorded in some patients with acute hydrogen cyanamide poisoning (Gamaluddin et al, 2012;El Mahdy and Kharoub, 2020;Sharif and Fayed, 2021). The main mechanism of nephrotoxicity of dormex is not yet known.…”

Unveiling the Deadly Effects of Hydrogen Cyanamide Poisoning: A Case Report

“…HIF-1α is a major factor regulating the cellular response to hypoxia, suggesting that hypoxia at the cellular level is associated with the encephalopathy [11] . Hypotension and shock are early symptoms observed in these patients, with a reported occurrence of 50% according to Gamaluddin H [5] . Sheshadri SH et al [12] proposed that this phenomenon may be attributed to a vasodilatory effect caused by nitro, resulting from the oxidation of hydrogen cyanamide by catalase.…”

“…Hydrogen cyanamide is highly toxic to humans and has been classified as a Class I toxicity (the highest toxicity category) by the Environmental Protection Agency (EPA) since 2003 [4] . Oral ingestion of hydrogen cyanamide poses the greatest risk, potentially leading to fatal consequences with a mortality rate of 33.3% [5] . Adverse outcomes occur in 86% of patients when the ingested dose exceeds 100 ml [2] .…”