Journal of the Chinese Medical Association
Volume 72, Issue 4 , Pages 214-218, April 2009

Acute Hemolysis Caused by Incidental Trichlorfon Exposure

  • Ming-Ling Wu

      Affiliations

    • Corresponding Author InformationCorrespondence to: Dr Ming-Ling Wu, Division of Clinical Toxicology, Department of Medicine, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.
    • ,
  • Jou-Fang Deng

Division of Clinical Toxicology, Department of Medicine, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.

Received 1 July 2008; accepted 23 December 2008.

Article Outline

Trichlorfon (o-o-dimethyl-2,2,2-trichloro-hydroxyethylphosphate), an organophosphate, has a moderately potent anti-cholinesterase activity. Organophosphate poisoning is well known for its characteristic symptoms and signs, but acute hemolysis caused by trichlorfon is rarely reported. We present a patient who developed acute hemolysis and renal function impairment after percutaneous trichlorfon exposure. A 54-year-old man applied trichlorfon powder to his dog to kill its parasites. Half an hour later, the dog was suspected to die of cholinergic crisis and the patient felt abdominal cramping pain. Later, he developed severe nausea, vomiting, chills, high fever, and cold sweat. Laboratory work-up disclosed a picture of acute hemolysis, jaundice, renal function impairment and leukocytosis. However, there were no clinical features of acute cholinergic syndrome except gastrointestinal symptoms, and blood cholinesterase activities were also normal. He eventually had a full recovery. Trichlorfon should be added to the toxins known to cause acute hemolysis.

Key Words:  acute hemolysis , acute trichlorfon poisoning , percutaneous exposure

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PII: S1726-4901(09)70058-9

doi:10.1016/S1726-4901(09)70058-9

Journal of the Chinese Medical Association
Volume 72, Issue 4 , Pages 214-218, April 2009

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