Journal of toxicology. Clinical toxicology
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J. Toxicol. Clin. Toxicol. · Jan 1996
ReviewBenefits of extracorporeal membrane oxygenation for hydrocarbon pneumonitis.
To review the therapeutic benefits of extracorporeal membrane oxygenation for the management of hydrocarbon pneumonitis. ⋯ The need for extracorporeal membrane oxygenation is rare owing to the generally good outcome of most cases of hydrocarbon ingestions and pneumonitis. Only with further research on the nature and clinical course of severe hydrocarbon pneumonitis, refinement of extracorporeal membrane oxygenation criteria, and evaluation of alternative therapies, will the benefits of extracorporeal membrane oxygenation be better defined.
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J. Toxicol. Clin. Toxicol. · Jan 1996
Review Case ReportsHemolysis after acetaminophen overdose in a patient with glucose-6-phosphate dehydrogenase deficiency.
A sixteen year-old-male with a history of glucose-6-phosphate dehydrogenase deficiency ingested an unknown amount of acetaminophen and presented to an emergency department 7.5 h later. He was afebrile. His serum acetaminophen level was 184 micrograms/mL, and his urine toxicologic screen was otherwise negative. Vomiting led to enrollment in a experimental protocol of intravenous N-acetylcysteine. He developed no evidence of subsequent chemical hepatitis but did develop a significant Coomb's negative hemolytic anemia. Hemoglobin on presentation was 14 g/dL and reached a nadir of 9.4 g/dL on admission day 4. ⋯ Patients with glucose-6-phosphate dehydrogenase deficiency who overdose with acetaminophen should be monitored for the possible development of subsequent drug-induced hemolysis.
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J. Toxicol. Clin. Toxicol. · Jan 1996
Review Case ReportsSalicylism from topical salicylates: review of the literature.
Although topical salicylates are widely used, toxicity from this route is rare. ⋯ Her serum salicylate fell to 1.90 mmol/L (26 mg/dL) over a two day period and she regained a normal mental status.
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To present a child who developed gastric ulcers and duodenal erosions after ingestion of hydrogen peroxide 3% and delineate the epidemiology, medical outcomes, and toxicity of exposures to this agent managed by a poison control center. ⋯ Exposure to hydrogen peroxide 3% is usually benign, however, severe gastric injury may occur following small ingestions in children. Patients who report persistent vomiting or bloody emesis require medical evaluation and consideration of endoscopy to evaluate gastrointestinal injury.
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J. Toxicol. Clin. Toxicol. · Jan 1996
Review Case ReportsHepatitis, rash and eosinophilia following trichloroethylene exposure: a case report and speculation on mechanistic similarity to halothane induced hepatitis.
A previously healthy 30-year-old male began work as a degreaser. The solvent used in the degreasing operation was trichloroethylene. Over the next month he experienced symptoms of weakness, dizziness, decreased appetite, nausea, abdominal pain, diarrhea, fever, chills, dry skin, red rash with bumps, peeling face, and itching. At that time he had marked liver enzyme elevation without evidence of cholestasis. CBC was remarkable for a significant number of atypical lymphocytes. Two weeks later his liver enzymes showed a marked reduction in ALT from a peak of 1250 IU to 717 IU. Tests for Hepatitis A, B, and C, CMV, HIV1 were all negative. The night following his first day back at work he had a recurrence of a red, diffuse rash without any consumption of alcohol. The rash caused tremendous itching. Over the next few days off work the rash continued and peeled. Physical examination one week after re-exposure was remarkable for diffuse, erythematous rash; some peeling skin and pitting edema to the knees. ALT was 517 IU/L. White blood cell count was 10,100/mm3 with 27% eosinophilia. ⋯ This patient had possibly experienced sensitization to trichloroethylene, or more likely, to one of its metabolites. Similar symptoms attributed to trichloroethylene have been reported in only a few other patients. Patch testing with trichloroethylene and its metabolites may better clarify a causal relationship in future patients. If an immune mechanism is involved it may be similar to one postulated for halothane induced hepatitis.