Citation

Gawarammana IB, Ariyananda PL, Palangasinghe C, De Silva NG, Fernando K, Vidanapathirana M, Kuruppuarachchi MA, Munasinghe MA, Dawson AH. Clin. Toxicol. (Phila) 2009; 47(5): 407-411.

Affiliation

Department of Clinical Medicine and South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka. indika@sactrc.org

Copyright

(Copyright © 2009, Informa - Taylor and Francis Group)

DOI

10.1080/15563650902915320

PMID

19492931

PMCID

PMC3145130

Abstract

INTRODUCTION: Self-poisoning is a public health problem in Sri Lanka. A new laundry detergent consisting of a sachet each of 1.2 g of potassium permanganate and 12.5 g of oxalic acid has become a popular agent among the youth for self-poisoning. METHOD: Prospective clinical data and major outcomes were recorded in all patients admitted to a referring and a referral hospital. Serial biochemistry was performed in 20 patients. Postmortem examinations were performed in some patients. RESULTS: There were 115 patients. The majority developed symptoms of the gastrointestinal tract within the first 24 h. There were 18 deaths. Ingestion of oxalic acid was associated with a case fatality ratio of 25.4% (95% CI = 14-39), while ingestion of both potassium permanganate and oxalic acid was associated with a case fatality ratio of 9.8% (95% CI = 3.2-21). Ingestion of more than one sachet was associated with a significantly higher risk of death (risk ratio = 13.26, 95% CI = 3.2-54, p < 0.05). Majority of the deaths occurred within an hour since ingestion. Postmortem examinations revealed mucosal ulceration in the majority of deaths. DISCUSSION: This case series brings to light an emerging epidemic of fatal self-poisoning in Sri Lanka from a compound that is not regulated. As deaths occur soon after ingestion, medical management of these patients is bound to be difficult. CONCLUSION: This case series highlights a fatal mode of self-poisoning that could be controlled through regulation of the manufacture and sale of the product.

Language: en