アミトラズ中毒。早期に胃洗浄を行うことで、生命を脅かす合併症を防ぐことができます

Amitraz poisoning: Early gastric lavage can prevent life-threatening complications.

• Pratti Madhuri
• Anirudh Mukherjee
• Sukdev Manna
• Minakshi Dhar

抄録

アミトラズは、動物と人間の両方に可逆的な毒性効果があることが証明されているホルムアミジン化学製品ファミリの世界的に利用可能な農薬です。摂取、吸入、または経皮経路による中毒時に、それは様々な中枢神経系（CNS）、CVS、呼吸器および消化管の影響を引き起こし、そのうちのいくつかは生命を脅かす可能性があります。特異的な解毒剤がないため、患者は通常、支持療法と対症療法で管理されている。症例は36歳女性で，アミトラズ120ml摂取の既往歴があるとされている．救急外来で活性炭を用いた早期胃洗浄を行い，支持療法と対症療法を行った．症状は軽度の中枢神経系の抑うつ，徐脈，ミオシス，血圧変動であった．集中治療室で管理され，血行動態の監視下に置かれていた．入院中の臨床経過は問題なく，後遺症を残すことなく無事に退院した．以前に発表されたデータによると，この量のアミトラズ中毒は，より重篤な臨床症状を引き起こす可能性があった．このような重篤な臨床症状は，早期に胃洗浄を行ったことに起因するものである。アミトラズ関連の健康被害を減らすための不吉なことは、プライマリヘルスケアの医師や政府の規制機関の手にあります。

Amitraz is a worldwide available pesticide of formamidine chemical family, proven to have reversible toxic effects on both animals and humans. Upon intoxication by ingestion, inhalation, or dermal route, it can cause various central nervous system (CNS), CVS, respiratory and gastrointestinal effects, some of which may be life threatening. Because of lack of specific antidote patients are usually managed with supportive and symptomatic management. We describe a case of 36-year-old female patient who presented to us with alleged history of 120 ml amitraz ingestion. She was given early gastric lavage with activated charcoal at emergency along with supportive and symptomatic management. She developed mild CNS depression, bradycardia, miosis, and fluctuating blood pressure. She was managed in intensive care unit and was kept under close hemodynamic monitoring. Her clinical course during hospital stay was uneventful and was successfully discharged without any residual deficits. According to previously published data, this amount of amitraz intoxication could have caused more serious clinical manifestations. This disproportionately less severe clinical manifestation in our patient is attributed to early gastric lavage. Ominous of reducing amitraz-related health hazards lies in the hands of primary health care physicians and regulatory bodies of government.

Copyright: © 2020 Journal of Family Medicine and Primary Care.