Citation

Park JS, Kim H, Lee SW, Min JH. Clin. Toxicol. (Phila) 2011; 49(8): 744-746.

Copyright

(Copyright © 2011, Informa - Taylor and Francis Group)

DOI

10.3109/15563650.2011.602080

PMID

21867363

Abstract

CONTEXT: We report a case of systemic toxicity induced by indoxacarb, an oxadiazine insecticide. Previous reports have suggested the occurrence of methemoglobinemia after indoxacarb ingestion, but no case of indoxacarb-induced systemic toxicity, such as acute renal failure, has been reported thus far.
CASE DETAILS: A 71-year-old woman presented with indoxacarb poisoning, resulting in methemoglobinemia and acute renal failure. The methemoglobinemia improved after methylene blue administration, but rapidly progressive acute renal failure occurred 7 h after admission. She was treated with continuous veno-venous hemofiltration and intravenous sodium bicarbonate and recovered successfully.
DISCUSSION: Ingestion of indoxacarb may produce not only methemoglobinemia, but also systemic toxicities like acute renal failure, which can be successfully treated with aggressive therapy such as continuous veno-venous hemofiltration. Physicians should be alert to acute renal failure as a possible complication of indoxacarb ingestion, and treat it accordingly.

Language: en

Keywords

Humans; Aged; Female; Poisoning; Treatment Outcome; Suicide, Attempted; Injections, Intravenous; Acute Kidney Injury; Insecticides; Hemofiltration; Methemoglobinemia; Oxazines; Sodium Bicarbonate