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Archives of Industrial Hygiene and Toxicology, Vol. 69 No. 2, 2018.

Professional paper

https://doi.org/10.2478/aiht-2018-69-3121

New insights into the organophosphate-induced intermediate syndrome

Raluca Ecaterina Haliga orcid id orcid.org/0000-0001-6788-6019 ; Department of Internal Medicine and Toxicology, “Sf. Spiridon” Clinical Emergency Hospital, University of Medicine and Pharmacy “Gr. T. Popa” Iasi, Romania
Bianca Codrina Morarasu orcid id orcid.org/0000-0002-5004-1009 ; Department of Internal Medicine, “Sf. Spiridon” Clinical Emergency Hospital, University of Medicine and Pharmacy “Gr. T. Popa” Iasi, Romania
Manuela Ursaru ; Department of Radiology and Imaging, “Sf. Spiridon” Clinical Emergency Hospital, University of Medicine and Pharmacy “Gr. T. Popa” Iasi, Romania
Viorica Irimioaia ; Department of Neurology, “Sf. Spiridon” Clinical Emergency Hospital, University of Medicine and Pharmacy “Gr. T. Popa” Iasi, Romania
Laurentiu Sorodoc ; Department of Internal Medicine and Toxicology, “Sf. Spiridon” Clinical Emergency Hospital, University of Medicine and Pharmacy “Gr. T. Popa” Iasi, Romania

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Abstract

Acute organophosphate (OP) poisoning can be deadlier than any other type of chemical poisoning. So far, only a few cases have been described that include extensive neurological complications. We present an outstanding case of severe oral OP poisoning with intermediate syndrome developed on the fourth day after hospital admission. The clinical picture involved weakness of the proximal upper and lower limb muscles and several muscles supplied by motor cranial nerves, but, what is peculiar, the distal upper and lower limb muscles were also affected (forearms, hands, legs, and feet). To our knowledge, this is a unique presentation, as lower limb muscle weakness was reported only in the context of delayed polyneuropathy. Another remarkable feature was the involvement of six of the twelve cranial nerves, which makes this case of intermediate syndrome the first with such a spread of muscle weakness and provides new insights into the polymorphic clinical manifestations of acute OP poisoning.

Keywords

cholinesterase; lower limb muscle weakness; motor cranial nerves; myasthenia; poisoning

Hrčak ID:

202290

URI

https://hrcak.srce.hr/202290

Publication date:

27.6.2018.

Article data in other languages: croatian

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