Epidemiology, toxicokinetics and biomarkers after self-poisoning with<i>Gloriosa superba</i>

Wijerathna, Thilini; Gawarammana, Indika; Mohamed, Fahim; Dissanayaka, Dhammika Menike; Dargan, Paul I.; Chathuranga, Umesh; Jayathilaka, Chamila; Buckley, Nicholas A.

doi:10.1080/15563650.2019.1581939

Cited by 8 publications

(3 citation statements)

References 37 publications

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“…The increased case fatality with increased age may be due to larger ingestions (perhaps due to greater suicidal intent) and/or underlying health/co-morbidity 11 , 12 . We have similarly noted that patients who died following ingestion of Gloriosa superba were older and had higher levels of plasma colchicine compared to survivors 13 .…”

Section: Discussionmentioning

confidence: 68%

“…Sporadic elevation of some biomarkers such as β2M, TFF3 and CytoC (Fig. 5 ) in patients with both AKI and No AKI might also be explained by cardiovascular or gastrointestinal toxicity 1 , 13 , 18 – 20 . Early increases in β2M 21 , and TFF3 22 concentrations might also be explained by pre-renal injury, that is the reversible loss of renal function without renal structural damage.…”

Section: Discussionmentioning

confidence: 99%

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Epidemiology and renal injury following 2-methyl-4-chlorophenoxyacetic acid (MCPA) poisoning

Wijerathna

Buckley

Gawarammana

et al. 2022

Sci Rep

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Abstract2-Methyl-4-chlorophenoxyacetic acid (MCPA) is a widely used chlorophenoxy herbicide. MCPA poisoning causes mitochondrial dysfunction, which can lead to kidney injury and death. The objective of this study is to describe the epidemiology, case fatality and extent of renal injury in a large cohort of MCPA self-poisonings. The study consists of two parts: (1) A report of epidemiological data and clinical outcomes in MCPA poisoned patients in Sri Lanka between 2002 and 2019; (2) Evaluation of acute kidney injury (AKI) using renal biomarkers in a subset from this cohort. Serum creatinine (sCr) and biomarkers were measured soon after hospitalization (2 [IQR 1–3] h) and at different time intervals. We measured serum biomarkers: sCr, cystatin C (sCysC), creatine kinase (CK), and urinary biomarkers: creatinine, kidney injury molecule-1 (KIM-1), clusterin, albumin, beta-2-microglobulin (β2M), cystatin C, neutrophil gelatinase-associated lipocalin (NGAL), osteopontin (OPN), trefoil factor 3 (TFF3) and cytochrome C (CytoC). Kidney Disease Improving Global Outcomes (KDIGO) criteria was used to define acute kidney injury (AKI). There were 1653 patients; 65% were male. The median time from ingestion to examination was 3:54 (IQR 2:19–6:57) h. The overall case-fatality rate was 5.3%. Patients who died were older (42 [IQR 33.5–54] vs 27 [IQR 20–37] for survivors). The median estimated amount of MCPA ingested by patients who died was also greater (88 [IQR 34–200] vs. 30 [IQR 15–63] ml in survivors). Moderate to severe AKI (AKI2/3) was uncommon (6/59 patients in the biomarker study had KDIGO stage 2 or 3). Most patients in AKI2/3 group with increased sCr were older (median age 35 years [IQR 27–41]) compared to No AKI (23 years (19–29) years) or AKI1 (26 years (21–40) years) group who had no or mild increase in sCr. These patients had no pre-existing kidney diseases. In these patients, serum creatinine (maximum medium concentration; 1.12 [IQR 0.93–1.67] mg/dl) and CK (maximum medium concentration; 284 [IQR 94–428] U/l) were increased but sCysC (maximum medium concentration; 0.79 [IQR 0.68–0.81] mg/l) remained in the normal range within 72 h. All urinary biomarkers performed poorly in diagnosing AKI (area under the receiver operating characteristic curve < 0.68). The higher numbers of men with MCPA poisoning likely reflects greater occupational access to pesticides. Fatal outcome and higher ingested dose were more common in the elderly. Significant AKI with tubular injury biomarkers was uncommon. Most people with raised sCr were older and appeared to have no pre-existing kidney disease.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Epidemiology and renal injury following 2-methyl-4-chlorophenoxyacetic acid (MCPA) poisoning

Wijerathna

Buckley

Gawarammana

et al. 2022

Sci Rep

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“…29 Sin embargo, en un estudio se encontró que en ancianos la concentración de colchicina se correlaciona directamente a su toxicidad. 30 El manejo inicial consiste en la descontaminación gástrica con carbón activado a 1 gr/Kg de peso. Si no se cuenta con éste, se puede realizar lavado gástrico dentro de la primera dos horas de la ingesta.…”

Section: Discussionunclassified