Ali DUYGU, Bahadır KIRILMAZ, Mehmet ARSLAN, Uğur KÜÇÜK

Zirai ilaç zehirlenmesi ile başvuran stent trombozu

İnsanların kimyasal maddelere maruz kalması büyüyen bir endişe kaynağıdır. Glifosat bazlı herbisit (GBH) kullanımı da akut zehirlenme sonucu çeşitli hastalıklara neden olur. GBH bazlı ilaçlar sinüs bradikardisi, QT uzaması, torsade de pointes, AV blok gibi elektrokardiyografi değişikliklerine ve nadiren koroner arter trombozu neden olabilir. 2 yıl önce ilaç kaplı stent uygulanmış olan 68 yaşında erkek hasta göğüs ağrısı şikayeti ile acil servise başvurdu. Hastadan alınan anamnezde GBH içeren zirai ilaç kullanarak 2 gündür tarlada maskesiz ilaçlama yaptığı, göğüs ağrısının başladığı ve acil servise başvurduğu anlaşıldı. Akut GBH entoksikasyonu hipotansiyon, solunum sıkıntısı, gastrointestinal semptomlar, bilinç kaybı, oligüri ve nadiren ölüme neden olabilir. GBH'ye kronik maruziyetin koroner arter hastalığına neden olduğu gösterilmiştir.

Anahtar Kelimeler:

Stent trombozu, Zehirlenme, glifosat bazlı herbisit

Stent thrombosis presenting with herbicide poisoning

Human exposure to chemical pollutants is a growing concern. The use of glyphosate-based herbicide (GBH) also causes various diseases because of acute poisoning. GBH-based drugs may cause electrocardiography changes such as sinus bradycardia, QT prolongation, torsade de pointes, AV block, and rarely coronary artery thrombosis. A 68-year-old male patient, who had undergone a drug eluted stent 2 years ago, was admitted to the emergency department with chest pain. In his anamnesis, it was noted that he had been spraying weed in the field without a mask for 2 days using an agricultural drug containing GBH, and he admitted to the emergency service with chest pain. Acute GBH intoxication may cause hypotension, respiratory distress, gastrointestinal symptoms, unconsciousness, oliguria, and rarely death. It was shown that chronic exposure to GBH causes coronary artery disease.

Keywords:

Stent thrombosis, glyphosate-based herbicide, poisoning,

PDF

___

1. Gress S, Lemoine S, Puddu PE, Séralini GE, Rouet R. Cardiotoxic electrophysiological effects of the herbicide Roundup® in rat and rabbit ventricular myocardium in vitro. Cardiovasc Toxicol 2015;15(4):324-35.
2. Gress S, Lemoine S, Séralini GE, Puddu PE. Glyphosate-based herbicides potently affect cardiovascular system in mammals: Review of the literature. Cardiovasc Toxicol 2015;15(2):117-26.
3. Roy NM, Ochs J, Zambrzycka E, Anderson A. Glyphosate induces cardiovascular toxicity in Danio rerio. Environ Toxicol Pharmacol 2016;46:292-300.
4. Kimmel GL, Kimmel CA, Williams AL, DeSesso JM. Evaluation of developmental toxicity studies of glyphosate with attention to cardiovascular development. Crit Rev Toxicol 2013;43(2):79-95.
5. Pan L, Xu M, Yang D, Wang B, Zhao Q, Ding E, Zhu B. The association between coronary artery disease and glyphosate exposure found in pesticide factory workers. J Public Health Emerg 2017;1:4.
6. Paumgartten FJR. Glyphosate exposure, cardiovascular diseases and cancer risks. J Public Health Emerg 2017;1:15.
7. Roberts DM, Buckley NA, Mohamed F, et al. A prospective observational study of the clinical toxicology of glyphosate-containing herbicides in adults with acute self-poisoning. Clin Toxicol (Phila) 2010;48(2):129-36.