Dinitro-Ortho-Cresol Maruziyeti Sonrasında Akut Koroner Sendrom Gelişen
Ardışık İki Hasta
Nitrophenols are common components of industrial effluents and have been detected in urban and agricultural waste. Dinitro-ortho-cresol (DNOC) can easily enter the body through inhalation, ingestion or the skin. Yellow staining is typical in toxications via skin contact. The main toxic effects of DNOC derivatives are due to an increase in cellular metabolism. It acts directly on metabolism by inducing cellular oxidation and inhibiting phosphorylation, leading to the uncoupling of oxidative phosphorylation. Cardiovascular effects appear to be secondary to cellular anoxia. We report here two consecutive patients admitted to the emergency department with an initial diagnosis of toxic exposure to DNOC. Further examination revealed that toxic exposure led to simultaneous acute coronary syndrome.
Two Consecutive Acute Coronary Syndrome Patients after Dinitro-Ortho-Cresol Exposure
Nitrophenols are common components of industrial effluents and have been detected in urban and agricultural waste. Dinitroortho-cresol (DNOC) can easily enter the body through inhalation, ingestion or the skin. Yellow staining is typical in toxications via skin contact. The main toxic effects of DNOC derivatives are due to an increase in cellular metabolism. It acts directly on metabolism by inducing cellular oxidation and inhibiting phosphorylation, leading to the uncoupling of oxidative phosphorylation. Cardiovascular effects appear to be secondary to cellular anoxia. We report here two consecutive patients admitted to the emergency department with an initial diagnosis of toxic exposure to DNOC. Further examination revealed that toxic exposure led to simultaneous acute coronary syndrome
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- Dere E, Ozdikicioglu F, Tosunoglu H. Hepatotoxicity of Dinitro-O-Cresol in Rats (Rattus norvegicus), Acta Vet (Beograd) 2007; 57: 497-507. [CrossRef]
- Lu YQ, Jiang JK, Huang WD. Clinical features and treatment in patients with acute 2,4-dinitrophenol poisoning. J Zhejian Univ-Sci B 2011; 12: 189-92. [CrossRef]
- National Research Council. Drinking Water and Health. Vol. 4. Washing- ton. National Academy Press; 1982.p.203.
- Bains France. World Health Organization/International Programme on Chemical Safety; Environmental Health Criteria 220 Dinitro-ortho-cresol. 2000.p.1-4.
- Harvey DG, Bidstrup PL, Bonnell JA. Poisoning by dinitro-ortho-cresol; some observations on the effects of dinitro-ortho-cresol administered by mouth to human volunteers. Br Med J 1951; 2: 13-6. [CrossRef]
- Ray S, Peters CA. Changes in microbiological metabolism under chemi- cal stress. Chemosphere 2008; 71: 474-83. [CrossRef]
- Bartlett J, Brunner M, Gough K. Deliberate poisoning with dinitrophenol (DNP): an unlicensed weight loss pill. Emerg Med J 2010; 27: 159-60. [CrossRef]
- Tewari A, Ali T, O’Donnell J, Butt MS. Weight loss and 2,4-dinitrophenol poisoning. Br J Anaesth 2009; 102: 566-7. [CrossRef]
- Brown, Michael A, Robert L. Chessin. Toxicological profile for dinitrocre- sols. Research Triangle Inst., Durham, NC (United States), 1995.p.31.
- Gosselin Robert E., Roger P. Smith, and Harold C. Hodge. Clinical toxi- cology of commercial products. 5th ed. Baltimore Williams & Wilkins, 1984..p.157.