Amitraz: an unusual aetiology of Ogilvie's syndrome

Aslan, Şahin; Bilge, Fatih; Aydınlı, Bülent; Ocak, Tarık; Uzkeser, Mustafa; Erdem, Alı Fuat; Katirci, Yavuz

doi:10.1191/0960327105ht550cr

Cited by 12 publications

(14 citation statements)

References 15 publications

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“…Recently, some reports on amitraz/xylene poisoning in adults have appeared [8,[10][11][12][13][14]. The typical symptoms of amitraz as an α 2 -adrenoreceptor agonist are considered to be miosis, hyperglycemia, hypotension, and bradycardia; those due to xylene are depression, ataxia, stupor, and coma [15].…”

Section: Poisoning Featuresmentioning

confidence: 99%

A near-fatal case of acute poisoning by amitraz/xylene showing atrial fibrillation

et al. 2007

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Amitraz has become a signifi cant cause of acute poisoning because of its wide use in veterinary medicine during the last decade. The majority of published cases of amitraz poisoning have dealt with children, while severe life-threatening poisoning in adults is very rare. In this report, the clinical and laboratory features in a case of acute poisoning by amitraz and xylene in an adult are presented. A 72-year-old man accidentally swallowed about 40 g of Mitac 20, a commercial formulation of amitraz dissolved in xylene. The ingested dose was estimated to be about 10 g of amitraz and 35 g of xylene. Initial symptoms were dizziness and nausea, followed by coma, respiratory insuffi ciency, miosis, and hyperglycemia. As an α 2 -adrenergic agonist, amitraz usually causes bradycardia, but the present patient showed atrial fi brillation with rapid ventricular response, which was successfully treated by digoxin. Amitraz itself and xylene metabolites were confi rmed in his blood and urine, respectively, by instrumental analysis. Supportive and symptomatic measures were taken over 3 days, and the patient recovered fully despite the signifi cant ingested amounts of amitraz and xylene.

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Section: Poisoning Featuresmentioning

confidence: 99%

A near-fatal case of acute poisoning by amitraz/xylene showing atrial fibrillation

et al. 2007

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“…α 2 adrenoceptor stimulation by amitraz has been shown to cause hypomotility of the gastrointestinal tract in dogs [33]. Ogilvie's syndrome characterized by abdominal pain, severe tenderness and distension which recovered after neostigmine administration was reported in a 36-year-old female following amitraz poisoning [34]. …”

Section: Discussionmentioning

confidence: 99%

“…However it may still be considered for treatment. In many cases, both gastric lavage and activated charcoal have been tried [10, 17, 20, 29, 34], Yilmaz et al recommend gastric lavage only in massive doses, to be performed after endotracheal intubation in order to avoid inhalation or aspiration pneumonitis [1]. Atropine has been used with success in patients who developed bradycardia [1, 6, 9, 10, 12, 29, 35].…”

Section: Discussionmentioning

confidence: 99%

Amitraz poisoning: A case report of an unusual pesticide poisoning in Sri Lanka and literature review

Herath

Pahalagamage

Yogendranathan

et al. 2017

BMC Pharmacol Toxicol

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BackgroundAmitraz is a pesticide used worldwide on animals and in agriculture. It contains triazapentadiene, which is a centrally acting alpha-2 adrenergic agonist. Amitraz poisoning is fairly uncommon in humans and occurs via oral, dermal or inhalational routes. Only a limited number of case reports of human intoxication have been published and most of them are of accidental ingestion by children.Case presentationA twenty-year-old Sri Lankan female presented following self-ingestion of 20 ml of amitraz resulting in 37.8 mg/ kg of amitraz poisoning. She lost consciousness after 20 min of ingestion, developed bradycardia and hypotension, which needed intravenous fluid resuscitation and dobutamine. Gastric lavage was performed. Her bradycardia persisted for 36 h and she was drowsy for 48 h. She did not develop respiratory depression, convulsions or hypothermia and the urine output was normal. Arterial blood gas revealed mild respiratory alkalosis. She recovered fully within 48 h and was discharged on day 3.ConclusionThe clinical manifestations of amitraz (impaired consciousness, drowsiness, vomiting, disorientation, miosis, mydriasis, hypotension, bradycardia, respiratory depression, hypothermia, generalized seizures, hyperglycemia and glycosuria) can be explained by the agonist action of amitraz on α1 and α2 receptors. Management of amitraz poisoning is still considered to be supportive and symptomatic with monitoring of nervous system, cardiovascular and respiratory systems. Activated charcoal may still be considered for treatment and the place for gastric lavage is controversial. Atropine is effective for symptomatic bradycardia and inotropic support is needed for hypotension that does not respond to fluid resuscitation. Diazepam or Lorazepam is used for convulsions and some patients may require intubation and ICU care. Several α2 adrenergic antagonists like yohimbine have been tried on animals, which have successfully reversed the effects of amitraz. Since the majority of amitraz poisoning cases are due to accidental ingestion, manufactures, regulatory authorities and national poisons control centers have a significant role to play in minimizing its occurrence.

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“…También se ha reportado su capacidad para inhibir la MAO, in vivo, pero no in vitro 11,12 . Se encuentran reportes de casos en los que hay manifestaciones como arritmias de puntas torcidas 13 o síndrome de Ogilvie, un tipo de pseudoparálisis intestinal 14 .…”

Section: Declaración De Conflicto De Interesesunclassified

Reporte de caso de intoxicación por amitraz

Rosas¹,

Mejía²

2017

MedUPB

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RESUMENLa intoxicación por amitraz es poco frecuente en Colombia. Los objetivos de este reporte de caso son evidenciar una presentación atípica de la intoxicación en un paciente de edad avanzada y resaltar aspectos toxico-cinéticos y toxico-dinámicos asociados. La literatura consiste, principalmente, en reportes de caso y series de casos y en Norteamérica. Existe la necesidad de que el personal de salud involucrado en el manejo de estos pacientes reconozca aspectos clave de su fisiopatología y tratamiento. El caso reportado es de un paciente masculino de 73 años, intoxicado por amitraz, que se presenta inicialmente sin alteraciones, y luego de 33 horas, presenta alteraciones del sensorio y compromiso respiratorio, por lo que requiere una disposición en Unidad de Cuidados Especiales (UCE). El paciente tiene evolución satisfactoria. Palabras clave: insecticidas; envenenamiento; fisiopatología. ABSTRACTAmitraz poisoning is not frequent in Colombia. The objectives of this case report are to consider the atypical poisoning in an elderly patient and to emphasize the associated toxic-kinetic and toxic-dynamic aspects. The literature mainly consists of case reports and case series in North America. There is a need for the health personnel involved in the treatment of these patients to recognize key aspects of its physiopathology and treatment. The case reported involves a male patient aged 73 with amitraz poisoning, initially without alterations after 33 hours, presenting sensory alterations and respiratory compromise requiring attention in the Special Care Unit (SCU). The patient recovered satisfactorily. Keywords: insecticides; poisoning; physiopathology. RESUMOA intoxicação por Amitraze é pouco frequente na Colômbia. Os objetivos deste relato de caso são evidenciar uma apresentação atípica da intoxicação num paciente de idade avançada e ressaltar aspectos toxico-cinéticos e toxico-dinâmicos associados. A literatura consiste, principalmente, em relato de caso e séries de casos e na América do Norte. Existe a necessidade de que o pessoal da saúde envolvido no manejo destes pacientes reconheça aspectos chave da sua fisiopatologia e tratamento. O caso reportado é de um paciente masculino de 73 anos, intoxicado por amitraz, que se apresenta inicialmente sem alterações, e logo de 33 horas, apresenta alterações do sensório e compromisso respiratório, pelo qual requere uma disposição em Unidade de Cuidados Especiais (UCE). O paciente tem evolução satisfatória.

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Amitraz: an unusual aetiology of Ogilvie's syndrome

Cited by 12 publications

References 15 publications

A near-fatal case of acute poisoning by amitraz/xylene showing atrial fibrillation

A near-fatal case of acute poisoning by amitraz/xylene showing atrial fibrillation

Amitraz poisoning: A case report of an unusual pesticide poisoning in Sri Lanka and literature review

Reporte de caso de intoxicación por amitraz

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