Metabolic acidosis in prometryn (triazine herbicide) self-poisoning.

Abstract

INTRODUCTION:

Prometryn is a triazine herbicide, which is one of the most extensively used groups of herbicides. The mechanism of acute triazine herbicide toxicity in humans is not known. We report a first case of acute prometryn poisoning.

CASE REPORT:

A 62-year-old male ingested 50 g of prometryn and ethanol in a suicide attempt. On arrival two hours after ingestion, he was somnolent and vomited. Seven hours after ingestion laboratory tests showed metabolic acidosis with a calculated anion gap of 47.5 mmol/L and lactate of 23.4 mmol/L. Gas chromatography/mass spectrometry revealed serum prometryn concentrations of 48.1 mg/L. Hemodialysis corrected metabolic acidosis, but the serum prometryn concentration increased to 67.7 mg/L. The lactate level after hemodialysis was 11.7 mmol/L and returned within normal limits 47 hours after ingestion. The patient was discharged without any sequelae after psychiatric evaluation.

CONCLUSION:

In high anion gap metabolic acidosis we should consider poisoning with prometryn and other triazine herbicides. Hemodialysis corrects metabolic derangements, but it does not lower serum prometryn concentration.

• Authors: Miran Brvar, Renata Okrajsek, Polona Kosmina, Feliks Staric, Rafael Kaps, Gordana Kozelj, Matjaz Bunc
• Journal: Clinical toxicology (Philadelphia, Pa.) (Clin Toxicol (Phila)) Vol. 46 Issue 3 Pg. 270-3 (Mar 2008) ISSN: 1556-3650 [Print] England
• PMID: 17924252 (Publication Type: Case Reports, Journal Article)

Chemical References

• Bicarbonates
• Herbicides
• Prometryne
• Lactic Acid

Topics

• Acidosis (chemically induced)
• Bicarbonates (blood)
• Gas Chromatography-Mass Spectrometry
• Herbicides (blood, poisoning)
• Humans
• Hydrogen-Ion Concentration
• Lactic Acid (blood)
• Male
• Middle Aged
• Prometryne (blood, poisoning)
• Renal Dialysis
• Suicide, Attempted