Copper Sulphae Poisoning – a clinical case report
Keywords:
copper, toxic hepatitis, haemolytic anaemia, penicillamineAbstract
Copper, along with other elements, has a vital role at the cellular
and organic level, participating in important enzymatic reactions.
Acute toxicity is seldom seen, is usually accidental and potentially fatal. Frequently found in African countries, where copper
sulphate is used as an emetic, there are very few published or known cases in Portugal.
The authors describe a clinical case of severe toxic hepatitis,
haemolytic anaemia, encephalopathy, erosive gastroduodenitis
and rhabdomyolysis, in an 84 year-old patient, admitted after attempted suicide by voluntary ingestion of nearly 120 g of copper
sulphate. The complementary studies, treatment and evolution are reported.
The rarity of copper sulphate poisoning, and the scarse experience in using penicillamine in this situation, led us to report
this case.
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References
Donald G Barceloux, Copper, Clinical toxicology 1999; 37(2): 217-230.
Meret S, Henkin RI. Simultaneous direct estimation by atomic absorption spectrophotometry of copper and zinc in serum, urine, and cerebrospinal fluid, Clin Chem 1971 ;17(5):369-373.
Cousins RJ, Absorption, transport, and hepatic metabolism of copper and zinc: special reference to metallothionein and ceruloplasmina, Physiol Rev 1985;65(2):238-309.
Schilsky ML. Wilson disease: genetic basis of copper toxicity and natural history, Semin Liver Dis 1996;16(1):83-95.
Stein RS, Jenkins D, Korns ME. Death after use of cupric sulfate as emetic, JAMA 1976;235(8):801.
Lamont DL, Duflou JA. Copper sulphate. Not a harmless chemical, Am J Forensic Med Pathol 1988 ;9(3):226-227.
Sontz E, Schwieger J. The “green water“ syndrome: copper-induced hemolysis and subsequent acute renal failure as consequence of religious ritual, Am J Med 1995; 98:311-315.
Kurisaki E, Kuroda Y, Sato M. Copper-binding protein in acute copper poisoning. Forensic Sci Int 1988 ;38(1-2):3-11.
Yang CC, Wu Ml, Deng JF. Prolonged hemolysis and methemoglobinemia following organic copper fungicide ingestion, Vet Human Toxicol 2004; 46(6):321-323.
Gulliver JM. A fatal copper sulfate poisoning. J Anal Toxicol 1991;15(6):341-342.
Faure A, Mathon L, Poupelin JC, Allaouchiche B, Chassard D. Acute cupric sulfate intoxication: pathophysiology and therapy about a case report, Ann Fr Anesth Reanim 2003;22(6):557-559.
Delgado IF, Paumgartten FJ. Pesticide use and poisoning among farmers from the county of Paty do Alferes, Rio de Janeiro, Brazil, Cad Saude Publica 2004;20(1):180-186.
Cartwright GE,Wintrobe MM. Copper metabolism in normal subjects, Am J Clin Nutr 1964;14:224-232.
Walsh FM, Crosson FJ, Bayley M, McReynolds J, Pearson BJ. Acute copper intoxication. Pathophysiology and therapy with a case report, Am J Dis Child 1977;131(2):149-151.
Kurisaki E, Kuroda Y, Sato M. Copper-binding protein in acute copper poisoning, Forensic Sci Int 1988;38(1-2):3-11.
Chuttani HK, Gupta PS, Gulati S, Gupta DN. Acute copper sulfate poisoning, Am J Med 1965;39(5):849-854.
Schwartz E, Schmidt E. Refractory shock secondary to copper sulfate ingestion, Ann Emerg Med 1986;15(8):952-954.
Patel KC, Kulkarni BS, Acharya VN. Acute renal failure and methaemoglobinaemia due to copper sulphate poisoning, J Postgrad Med 1976;22(4):180-184.
Takeda T, Yukioka T, Shimazaki S. Cupric sulfate intoxication with rhabdomyolysis, treated with chelating agents and blood purification, Intern Med 2000;39(3):253-255.
Jantsch W, Kulig K, Rumack BH. Massive copper sulfate ingestion resulting in hepatotoxicity, J Toxicol Clin Toxicol 1984-85;22(6):585-588.
Isolauri J, Markkula H, Auvinen O. Copper sulfate corrosion and necrosis of the esophagus and stomach. Case report., Acta Chir Scand 1986; 152:701-702.
Klaassen CD. Heavy metals and heavy-metal antagonists, Ch. 66, In Hardman JG, Limbird LE eds, The pharmacological basis of therapeutics, 9/e, New York, Goodman & Gilman’s 1996:1649-1671
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