Journal of toxicology. Clinical toxicology
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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.
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J. Toxicol. Clin. Toxicol. · Jan 1996
An evaluation of unleaded petrol as a harm reduction strategy for petrol sniffers in an aboriginal community.
In mid 1989, leaded petrol was replaced by unleaded petrol to reduce lead toxicity in petrol sniffers in Maningrida, a remote Aboriginal community in Northern Australia. RETROSPECTIVE REVIEWS: Hospital admissions between 1987 and 1992 due to petrol sniffing were compared for Maningrida and a community using only leaded petrol. ⋯ The elimination of tetraethyl lead from petrol resulted in a significant decrease in hospitalization of petrol sniffers.
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J. Toxicol. Clin. Toxicol. · Jan 1996
Clinical TrialThe use of ondansetron in the treatment of nausea and vomiting associated with acetaminophen poisoning.
Nausea and vomiting associated with poisoning can complicate treatment and in some cases delay potential antidote administration. Side effect such as lowering the seizure threshold may at times discourage the use of traditional phenothiazine and butyrophenone antiemetics. ⋯ Ondansetron appears to be a potentially useful adjunct in the management of nausea and vomiting associated with acetaminophen poisoning.
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J. Toxicol. Clin. Toxicol. · Jan 1996
Case ReportsAcute renal failure, compartment syndrome, and systemic capillary leak syndrome complicating carbon monoxide poisoning.
Five Indian labourers sharing one room were found lying on the floor unconscious. A coal fire had been lit to provide heat during the cold night and was still burning inside the room. Two of the men were pronounced dead at the scene. ⋯ Two patients developed anuric acute renal failure due to acute tubular necrosis as shown by renal biopsy. Two patients developed the full blown picture of systemic capillary leak syndrome. Gross and microscopic examination of specimens taken at autopsy showed extensive necrosis of all skeletal muscles, myocardial necrosis and acute tubular necrosis affecting both kidneys.
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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.