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Inflammatory cytokines in patients with pesticide poisoning: a pilot study
Hyun Joon Kim, Wook-Joon Kim, Dong Wook Lee, Seung-Hyun Jung, Nam-Jun Cho, Samel Park, Eun Young Lee, Hyo-Wook Gil
J Korean Soc Clin Toxicol. 2022;20(1):15-21.   Published online June 30, 2022
DOI: https://doi.org/10.22537/jksct.2022.20.1.15
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AbstractAbstract PDF
Purpose: Acute pesticide poisoning is lethal and can lead to death. A few studies about the effects of acute pesticide poisoning have focused on the immune system. In the current study, we preliminarily investigated the changes in blood inflammatory cytokine levels in acute pesticide poisoning patients. Methods: In this study, we prospectively investigated the inflammatory cytokines in patients with acute pesticide poisoning. This study included patients admitted from February 2021 to November 2021 with a diagnosis of intentional poisoning by pesticide ingestion. The inflammatory cytokines measured were IFN-γ, IL-1β, IL-6, and TNF-α. Results: Totally, 27 patients were enrolled in this study. The types of pesticide ingested were glufosinate (n=6), glyphosate (n=8), organophosphate (n=4), pyrethroid (n=2), and others (n=7). The levels of inflammatory cytokines obtained were as follows: IFN-γ 2.78±8.03 pg/ml, IL-1β 2.62±2.03 pg/ml, IL-6 44.58±80.16 pg/ml, and TNF-α 11.80±15.60 pg/ml. The overall mortality rate was 11.1% (3/27), and levels of IL-1β and TNF-α were significantly higher in the death group compared to the survival group. Conclusion: Increased levels of IL-6 and TNF-α were observed in patients with acute pesticide poisoning. IL-1β and TNF-α were significantly higher in the death group as compared to the survival group. Our results indicate the occurrence of an inflammatory response due to the activation of immune cells by pesticide poisoning. Future large-scale studies need to be conducted to investigate the application of inflammatory cytokines as predictors and therapeutic targets.
Risk Factors to Predict Acute Respiratory Failure in Patients with Acute Pesticide Poisoning
Nam-Jun Cho, Samel Park, Eun Young Lee, Hyo-Wook Gil
J Korean Soc Clin Toxicol. 2020;18(2):116-122.   Published online December 31, 2020
DOI: https://doi.org/10.22537/jksct.2020.18.2.116
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AbstractAbstract PDF
Acute respiratory failure is an important risk factor for mortality in patients with acute pesticide poisoning. Therefore, it is necessary to investigate the risk factors to predict respiratory failure in these patients. This study retrospectively investigated the clinical features of respiratory failure among patients with acute pesticide poisoning requiring mechanical ventilation. This study included patients who were admitted with intentional poisoning by pesticide ingestion from January 2017 to December 2019. Paraquat intoxication was excluded. Among 469 patients with acute pesticide poisoning, 398 patients were enrolled in this study. The respiratory failure rate was 30.4%. The rate of respiratory failure according to the type of pesticide was carbamate (75.0%), organophosphate (52.6%), glufosinate (52.1%), glyphosate (23%), pyrethroid (8.9%), and others (17%). The mortality was 25.6% in the respiratory failure group. The risk factors for respiratory failure were old age, low body mass index, and ingestion of more than 300 mL. In conclusion, respiratory failure is a risk factor for mortality in pesticide poisoning. Old age, low body mass index, and ingestion of more than 300 mL are the risk factors for predicting respiratory failure.

Citations

Citations to this article as recorded by  
  • The 2022 Annual Report on Toxicology Surveillance and Severe Poisoning Cases at Emergency Departments in Korea
    Eun Sun Lee, Su Jin Kim, Gyu Chong Cho, Mi Jin Lee, Byung Hak So, Kyung Su Kim, Juhyun Song, Sung Woo Lee
    Journal of The Korean Society of Clinical Toxicology.2023; 21(1): 1.     CrossRef
  • Machine Learning-Based Prediction Models of Acute Respiratory Failure in Patients with Acute Pesticide Poisoning
    Yeongmin Kim, Minsu Chae, Namjun Cho, Hyowook Gil, Hwamin Lee
    Mathematics.2022; 10(24): 4633.     CrossRef
Fatal Brain Injury in Pyrethroid Poisoned Patient: Case Report
Woo Jin Jung, Yong Sung Cha, Dong Keon Lee, Hyun Kim
J Korean Soc Clin Toxicol. 2014;12(2):88-91.   Published online December 31, 2014
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AbstractAbstract PDF
Pyrethroids have been widely using insecticides. Although generally regarded as less toxic to mammals including humans, we report one fatal case of pyrethroid poisoning with severe brain injury.
The Study of Pyrethroid Intoxication: The basis of Agrichemical Intoxication Survey in 2005
Ah-Jin Kim, Kyung-Hwan Kim, Joon-Seok Park, Eun-Kyung Eo, Bum-Jin Oh, Mi-Jin Lee, Sung-Woo Lee, Joo-Hyun Suh, Hyung-Keun Roh
J Korean Soc Clin Toxicol. 2007;5(2):99-105.   Published online December 31, 2007
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AbstractAbstract PDF
Purpose: Pyrethroid is an insecticide that produces moderate intoxication in mammals, with neither exposure to skin nor inhalation resulting in severe systemic manifestations. In 2005 we made a nationwide survey of agrichemical human intoxication. The object of this study is to analyze pyrethroid intoxications based on the 2005 survey. Methods: We prospectively collected data from 1 August 2005 to 31 July 2006 by a standard investigation protocol. We analyzed demographic data, exposure data (cause, amount, ingredients), clinical features, and courses. Results: A total of 125 cases of pyrethroid intoxication were surveyed. The mean patient age was $56.78{pm}16.158$ years old, and the mean amount ingested was $121.85{pm}110.732ml$. Patients were classified into four severity groups according to symptoms and mental status: the asymptomatic group (27 patients, 21.6%), the mild symptom group (48, 38.4%), the moderate symptom group (21, 16.8%), and the severe symptom group (7, 5.6%). There were statistically significant differences in mental status, severity, and mean ICU days between two groups. Admission days by severity grade for the asymptomatic, mild, moderate, and severe symptom groups were $5.49{pm}16.051,;3.65{pm}4.143,;4.59{pm}3.335,;and;8.14{pm}7.199days$, respectively (p=0.047). Conclusion: Nationwide surveillance was extremely telling in uncovering a high frequency of agrichemical intoxication in Korea. In pyrethroid intoxication, severity grading can be a useful prognostic tool.
Organophosphate-Pyrethroid Mixtures Poisoning
Dae-Young Hong, Kwang-Je Baek, Kyeong-Ryong Lee, Woon-Yong Kwon, Joon-Seok Park, Eun-Kyung Eo, Bum-Jin Oh, Mi-Jin Lee, Sung-Woo Lee, Joo-Hyun Suh, Hyung-Keun Roh, Jun-Sig Kim
J Korean Soc Clin Toxicol. 2007;5(1):21-26.   Published online June 30, 2007
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AbstractAbstract PDF
Purpose: Owing to organophosphate-pyrethroid mixtures are widely used, suicidal or unintentional poisoning is common. But there have been relatively few reports of poisoning. The purpose of this study is to evaluate the difference of the severity and toxicity between organophosphate-pyrethroid mixtures poisoning and single organophosphate poisoning. Methods: From August 2005 to July 2006, 65 patients presented with organophosphate-pyrethroid mixtures poisoning to emergency medical center. Date were gathered by report form it was drawn up. Results: 65 patients were enrolled in 28 hospitals and their mean age was $56.5{pm}16.2$ years old. The most common cause of poisoning was suicide, in 52 cases(80%). Chlorpyrifos-cypermethrin, malathion-esfenvalerate were the most frequent chemicals involved, and the mean ingestion amount was 135.4ml. The most common symptom of the patients was nausea/vomiting, in 16 patients. The average GCS score was 13. The mean ICU stay was $4.4{pm}5.2$ days, and mortality was 3.1%. Conclusion: The severity and toxicity of organophosphate-pyrethroid mixture poisoning were lower than that of single organophosphate poisoning.

JKSCT : Journal of The Korean Society of Clinical Toxicology