Clinical presentation of type 1 and type 2 pyrethroid poisoning in humans

Jacob, Manna Sera; Iyyadurai, Ramya; Jose, Arun; Fleming, Jude Joseph; Rebekah, Grace; Zachariah, Anand; Hansdak, Samuel George; Alex, Reginald; Chandiraseharan, Vignesh Kumar; Lenin, Audrin; Peter, John Victor

doi:10.1080/15563650.2021.1994145

Cited by 5 publications

(7 citation statements)

References 17 publications

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“…According to an acute poisoning study in humans, serum levels of pyrethroids ranged from 1.1 to 453 μg/ml. 41 In the rat's toxicokinetics study for cypermethrin, serum level can reach 0.141 ± 0.021 μg/ml at 2.5 h (about 2 twice t1/2) after a single dose of 3.2 mg/kg to rats. 42 In this case, the dose we used in this study may be within the acute poisoning dose range.…”

Section: Discussionmentioning

confidence: 99%

“…In some cases for acute poisoning of cypermethrin, its dose was much high, while concentration for the general population may be much low. According to an acute poisoning study in humans, serum levels of pyrethroids ranged from 1.1 to 453 μg/ml 41 . In the rat's toxicokinetics study for cypermethrin, serum level can reach 0.141 ± 0.021 μg/ml at 2.5 h (about 2 twice t1/2) after a single dose of 3.2 mg/kg to rats 42 .…”

Section: Discussionmentioning

confidence: 99%

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Cypermethrin inhibits Leydig cell development and function in pubertal rats

Wang

Zou

et al. 2022

Environmental Toxicology

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Cypermethrin is a broad‐spectrum pyrethroid insecticide that is widely used. It may induce adverse endocrine‐disrupting effects on the male reproductive system. Whether cypermethrin can disrupt Leydig cell development and function in the late puberty remains elusive. The objective of this study was to explore the effect of cypermethrin exposure to male rats on the development and function of Leydig cells in late puberty and explore the underlying mechanism. Thirty‐six male Sprague–Dawley rats (age of 35 days) were gavaged with cypermethrin (0, 12.5, 25, and 50 mg/kg/day) from postnatal day 35–49. Cypermethrin significantly lowered serum testosterone level while elevating serum luteinizing hormone level at a dose of 50 mg/kg, without altering serum follicle‐stimulating hormone level. Cypermethrin markedly decreased CYP11A1‐positive Leydig cell number at 50 mg/kg without affecting SOX9‐positive Sertoli cell number. It significantly down‐regulated the expression of Leydig cell genes, Lhcgr, Star, Cyp11a1, and Cyp17a1 and their proteins, while up‐regulating the expression of Sertoli cell genes, Dhh and Amh, and their proteins, at doses of 12.5–50 mg/kg. In addition, cypermethrin significantly increased malondialdehyde level while lowering the expression of Sod1 and Sod2 and their proteins at 50 mg/kg. Cypermethrin markedly induced reactive oxidative species at a concentration of 200 μM and reduced mitochondrial membrane potential at 25 μM and higher concentrations after 24 h of treatment to primary Leydig cells in vitro. In conclusion, cypermethrin inhibits the development and function of Leydig cells in male rats in late puberty.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cypermethrin inhibits Leydig cell development and function in pubertal rats

Wang

Zou

et al. 2022

Environmental Toxicology

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“…The respiratory failure rates were 15.0%, 50.8%, and 42.5% after chlorpyrifos poisoning in three other studies. 1 , 8 , 11 Moreover, Jacob et al 13 disclosed that only 5.6% of patients with cypermethrin poisoning developed acute respiratory failure. Chlorpyrifos associated respiratory failure can be classified into two types depending on the time of onset after exposure.…”

Section: Discussionmentioning

confidence: 99%

“…As shown in Table 1, clinical research on the toxicity of chlorpyrifos and cypermethrin pesticide mixture poisoning are sparse in the literature, and confined to one original research. 1,[8][9][10][11][12][13] In a retrospective study of pesticide poisoning database, Iyyadurai et al 12 presented that patients with chlorpyrifos and cypermethrin pesticide mixture poisoning suffered lesser ventilator-free days than patients poisoned by either of the pesticides alone. The mortality rate was not significantly different among the three groups.…”

Section: Introductionmentioning

confidence: 99%

Human Poisoning with Chlorpyrifos and Cypermethrin Pesticide Mixture: Assessment of Clinical Outcome of Cases Admitted in a Tertiary Care Hospital in Taiwan

Wu,

Chang,

Chen

et al. 2023

IJGM

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Background and Purpose There is an overall paucity of data regarding the human toxicity of chlorpyrifos and cypermethrin pesticide mixture. Both organophosphate and pyrethroid insecticides are metabolized by carboxylesterases. Thus, its pesticide combination, organophosphates may boost the toxicity of pyrethroids via inhibited its detoxification by carboxylesterases. This study examined the clinical course, laboratory tests, and outcomes of patients with chlorpyrifos, cypermethrin or their pesticide mixture poisoning, and to determine what association, if any, might exist between these findings. Patients and Methods Between 2000 and 2021, 121 patients poisoned with chlorpyrifos, cypermethrin, or their pesticide mixture were treated at Chang Gung Memorial Hospital. Patients were categorized as chlorpyrifos (n=82), cypermethrin (n=27) or chlorpyrifos and cypermethrin (n=12) groups. Demographic, clinical, laboratory and mortality data were collected for analysis. Results The patients experienced a broad range of clinical symptoms, including aspiration pneumonia (44.6%), salivation (42.5%), acute respiratory failure (41.3%), acute kidney injury (13.9%), seizures (7.5%), hypotension (2.6%), etc. Leukocytosis (12,700±6600 /uL) and elevated serum C-reactive protein level (36.8±50.4 mg/L) were common. The acute respiratory failure rate was 41.3%, comprising 48.8% in chlorpyrifos, 11.1% in cypermethrin as well as 58.3% in chlorpyrifos and cypermethrin poisoning. Patients with chlorpyrifos and cypermethrin pesticide mixture poisoning suffered higher rates of acute respiratory failure (P=0.001) and salivation (P=0.001), but lower Glasgow Coma Scale score (P=0.011) and serum cholinesterase level (P<0.001) than other groups. A total of 17 (14.0%) patients expired. The mortality rate was 14.0%, including 17.1% in chlorpyrifos, 3.7% in cypermethrin as well as 16.7% in chlorpyrifos and cypermethrin poisoning. No significant differences in mortality rate were noted (P=0.214). Conclusion Chlorpyrifos pesticide accounted for the major toxicity of the pesticide mixture. While the data show a higher rate of respiratory failure in the chlorpyrifos and cypermethrin pesticide mixture group than others, other measures of toxicity such as mortality and length of stay were not increased.

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“…Clinical manifestations in patients who ingest type II pyrethroid compounds can include nausea, vomiting, tremors, paresthesia, hypersalivation, seizures, and a depressed sensorium 6 , 9 , 10 . In our case, our patient suffered from abdominal pain, nausea, vomiting, confusion, and decreased consciousness following the ingestion of lambda-cyhalothrin while under the influence of alcohol.…”

Section: Discussionmentioning

confidence: 99%

Lambda-cyhalothrin ingestion: an infrequent yet concerning presentation of pyrethroid poisoning

Silwal,

Adhikari,

Yadav

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction and importance: Lambda-cyhalothrin is a type II pyrethroid compound commonly used as a pesticide, with the potential to cause life-threatening toxicity in humans. Furthermore, among cases of pesticide poisoning in Nepal, organophosphates are most frequently implicated. Case presentation: A 40-year-old female presented to our hospital after ingesting a pesticide compound with suicidal intent. She also admitted to alcohol intoxication and exhibited symptoms of confusion, abdominal pain, nausea, and vomiting. An atropine challenge test yielded negative results. Therefore, conservative management was continued. It was discovered later that the ingested pesticide was lambda-cyhalothrin. The patient’s condition eventually improved with supportive treatment. Clinical discussion: Several reports have highlighted the overlapping clinical features between organophosphorus and pyrethroid poisoning. In some cases of pyrethroid poisoning, misdiagnosis as organophosphorus poisoning has occurred, leading to the inappropriate administration of atropine. In our case, initial management was challenging owing to the lack of accurate information about the ingested compound. On further evaluation, cholinergic clinical features were absent and the atropine challenge test was negative. This was suggestive of nonorganophosphorus compound poisoning. Conclusion: This case illustrates that managing pesticide poisoning becomes challenging when the nature of the pesticide is unknown. Patients suffering from poisoning caused by pyrethroid compounds like lambda-cyhalothrin can present with features resembling organophosphorus poisoning. In such circumstances, a comprehensive clinical evaluation should guide the management. Clinical features and an atropine challenge test can aid in differentiating organophosphorus from nonorganophosphorus compound poisoning. This distinction facilitates therapeutic decision-making, including the consideration of atropine administration.

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Clinical presentation of type 1 and type 2 pyrethroid poisoning in humans

Cited by 5 publications

References 17 publications

Cypermethrin inhibits Leydig cell development and function in pubertal rats

Cypermethrin inhibits Leydig cell development and function in pubertal rats

Human Poisoning with Chlorpyrifos and Cypermethrin Pesticide Mixture: Assessment of Clinical Outcome of Cases Admitted in a Tertiary Care Hospital in Taiwan

Lambda-cyhalothrin ingestion: an infrequent yet concerning presentation of pyrethroid poisoning

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