1/48. tremor and seizures associated with chronic manganese intoxication.tremor and seizures developed in a 2-year-old girl receiving total parenteral nutrition. T1-weighted images on MRI revealed areas of hyperintensity in the basal ganglia, brainstem and cerebellum. blood manganese was elevated. The symptoms and MRI abnormalities disappeared after withdrawal of manganese administration. The recommendation of daily parenteral manganese intake was discussed.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
2/48. A case of adult chronic copper self-intoxication resulting in cirrhosis.Copper "supplements" taken in a dose of 30-60 mg/day during 3 years caused severe liver cirrhosis necessitating orthotopic liver transplantation.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
3/48. Chronic intoxication by doxycycline use for more than 12 years.We report the clinical case of a 12-years' intoxication by doxycycline. A patient with a depersonalization and derealization syndrome took 1 g doxycycline per day. In addition to hepatocellular necrosis with cholestasis, nephrotoxicity, leukopenia, anaemia and skin hyperpigmentation he suffered from hitherto unreported adverse cardiac events as intermittent supraventricular tachycardia and sporadic Wenckebach heart block. Despite a long period of self-medication these side-effects were reversible.- - - - - - - - - - ranking = 1.25keywords = intoxication (Clic here for more details about this article) |
4/48. Chronic interstitial nephritis following parenteral copper sulfate poisoning.A 21-year-old male patient was admitted with acute renal failure and intravascular hemolysis following suicidal parenteral copper sulfate poisoning. He developed metabolic acidosis and septicemia; and was treated with intensive hemodialysis, blood transfusions and antibiotics. After remaining anuric for 4 weeks, his urine output gradually increased. However his renal functions improved only partially. Renal biopsy done 8 weeks after the episode showed chronic tubulo-interstitial nephritis (CIN). This is the first reported case showing CIN following acute copper sulfate intoxication.- - - - - - - - - - ranking = 0.25keywords = intoxication (Clic here for more details about this article) |
5/48. Secondary progressive chronic manganism associated with markedly decreased striatal D2 receptor density.We describe a patient with chronic manganism due to intoxication 40 years ago. Whereas previous reports on acute or subacute intoxication have shown no or only small reductions in striatal D2 receptor density, we found markedly decreased D2 receptor density using (18)F-methylspiperone PET in this very late stage of chronic manganism, supporting the hypothesis that manganese intoxication may trigger a neurodegenerative disease process.- - - - - - - - - - ranking = 0.75keywords = intoxication (Clic here for more details about this article) |
6/48. Chronic arsenic poisoning masquerading as Landry-guillain-barre syndrome.Acute arsenic intoxication may present as Landry-guillain-barre syndrome because of similarities in clinical symptoms involving the gastrointestinal tract, weakness, and sensory symptoms. Electrodiagnostic findings may be similar with demyelinating changes predominating early in both diseases. A case is presented of repeated arsenic poisoning over two years misdiagnosed as Landry-guillain-barre syndrome. Proximal F-loop latency (M-wave latency at wrist F-wave latency at wrist - 2 M-wave latency at axilla) helped to establish the correct diagnosis. Serial electrodiagnostic studies were done documenting the evolution of chronic repeated arsenic poisoning from a picture showing demyelination to one with severe axonal loss.- - - - - - - - - - ranking = 0.25keywords = intoxication (Clic here for more details about this article) |
7/48. Emergence of imported ciguatera in europe: report of 18 cases at the Poison Control Centre of Marseille.BACKGROUND: Ciguatera is a disease caused by the ingestion of fish containing the toxins of Gambierdiscus toxicus. This dinoflagellate is frequently found in damaged coral reef systems. Previously rare in europe, this disease entity is now seen in tourists returning from tropical countries. CASE SERIES: Eighteen patients were examined between 1997 and 2002. Nine poisonings occurred in atlantic ocean islands, eight in pacific ocean islands, and one in the Egyptian Red Sea coast. Gastrointestinal signs were always present in the Atlantic areas, but were less severe or absent in the Pacific areas. All patients had sensory disturbances, and two of them had motor disturbances affecting the respiratory muscles and leading to the death of a 73-year-old man in cuba. The 17 surviving patients returned to france and for 2 to 18 months suffered from arthralgias, myalgias, or pruritis. CONCLUSION: Ciguatera is a newly imported intoxication in europe. As the number of international tourists grows each year, this type of poisoning will be seen more frequently. Furthermore, as the condition of coral reefs declines around the world and the prevalence of G. toxicus increases, physicians in non-tropical countries should be prepared to manage such poisoned patients.- - - - - - - - - - ranking = 0.25keywords = intoxication (Clic here for more details about this article) |
8/48. hair analysis differentiates chronic from acute carbamazepine intoxication.This is a report of a 12-year-old epileptic child undergoing chronic treatment with carbamazepine who was found comatose. He was considered to have acute severe drug toxicity. Measurement of carbamazepine concentration in the patient's hair segments together with the carbamazepine blood levels were both important in determining the chronic nature of the patient's intoxication.- - - - - - - - - - ranking = 1.25keywords = intoxication (Clic here for more details about this article) |
9/48. water intoxication presenting as a suspected contaminated urine sample for drug testing.A patient was evaluated medically after submitting a urine sample for drug screening that was considered inappropriately dilute. Although it was thought that the dilute urine was the result of purposely adding water, the medical evaluation revealed that the patient had chronic water intoxication from a very strict weight loss regimen. The effect of dietary solute intake on water metabolism by the kidneys and the development of hyponatremia are discussed.- - - - - - - - - - ranking = 1.25keywords = intoxication (Clic here for more details about this article) |
10/48. life-threatening serotonin syndrome in a patient with chronic heart failure and CYP2D6*1/*5.We report a case of serotonin syndrome that occurred in a patient with chronic heart failure associated with a panic disorder. The 39-year-old Japanese man had been treated with paroxetine at 20 mg/d for 1 1/2 years. He presented with rhabdomyolysis, renal failure, fulminant liver failure, cardiac conduction disturbance, and disseminated intravascular coagulation, as well as conventional symptoms of serotonin syndrome including alterations in cognition (disorientation, confusion) and behavior (restlessness), autonomic nervous system dysfunction (fever, shivering), and abnormal neuromuscular activity (ataxia, hyperreflexia, myoclonus). All medications prescribed before hospital admission were discontinued. After 24 hours of continuous venovenous hemofiltration, diuresis resumed and renal and liver function improved rapidly. Disorientation, restlessness, hyperreflexia, and myoclonus abated slowly over the next 72 hours. The patient's anxiety subsided more slowly, and he recovered completely 1 week later. The plasma concentration of paroxetine was elevated far above the upper limit of the therapeutic range. The patient had cytochrome P-450 (CYP) 2D6*1/*5, a heterozygosity of an inactivated allele of CYP2D6, which metabolizes paroxetine. The patient was determined to be an intermediate metabolizer who was potentially vulnerable to paroxetine, a major inhibitor of CYP2D6. heart failure is often accompanied by psychiatric disorders. A wide range of drugs commonly prescribed for these conditions, including beta-blockers, antiarrhythmics, and antidepressants, are metabolized by CYP2D6. Genetic screening for CYP2D6 in patients with these conditions may prevent life-threatening drug intoxication.- - - - - - - - - - ranking = 0.25keywords = intoxication (Clic here for more details about this article) |
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