Permethrin emulsion ingestion: clinical manifestations and clearance of isomers

Journal of Toxicology. Clinical Toxicology
Y GotohY Okada

Abstract

Oral intoxication with permethrin, an insecticide which prolongs axonal sodium channel depolarization, has not been documented in humans. We treated a 59-year-old man who drank approximately 600 mL of 20% permethrin emulsion in a suicide attempt. Sequential blood samples were obtained to determine permethrin isomer levels using high-performance liquid chromatography. Vomiting and diarrhea occurred after ingestion. On admission, loss of consciousness and metabolic acidosis were observed. On regaining consciousness, the patient complained of a burning sensation in the oral cavity. He received fluid therapy after gastric lavage and recovered without severe complications. Apart from initially impaired consciousness, no clinical neurotoxicity such as tremor, hyperexcitation, ataxia, convulsions, or paralysis occurred, though these have been reported in permethrin-intoxicated animals. Serum permethrin concentrations peaked 3-4 hours after ingestion at 868 ng/mL. Clearance of trans permethrin was more rapid than that of cis permethrin. The unequal clearance of permethrin isomers paralleled findings in animal experiments. Vomiting and diarrhea probably limited absorption in the present case, resulting in a peak serum concentration and ...Continue Reading

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Citations

Dec 10, 2014·Pediatric Dermatology·Sevil B GoksugurFatih Demircioglu
Feb 25, 2006·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Daniel L Sudakin
Aug 4, 2012·Toxicological Sciences : an Official Journal of the Society of Toxicology·Rogelio Tornero-VelezMichael F Hughes
Dec 18, 2013·Occupational and Environmental Medicine·Peter KegelBernd Rossbach
Sep 27, 2005·Toxicological Reviews·Sally M BradberryJ Allister Vale
Jun 19, 2013·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·A GiampretiL Manzo
Mar 24, 2009·Journal of Occupational and Environmental Hygiene·Caroline CoutureMichèle Bouchard
Jan 24, 2016·Toxicology and Applied Pharmacology·Marie-Emilie WilleminCéline Brochot
Jan 29, 2002·Toxicology·David M SoderlundMyra L Weiner

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