A Case Report of Deep Coma in A Pregnant Women with Amitraz Poisoning

Document Type : Case report

Authors

1 Assistant Professor, Department of Toxicology, Addiction Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Resident of Emergency Medicine, Addiction Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Psychiatrist, Addiction Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 M.Sc. Student of Biochemistry, Payam Noor University of Mashhad, Mashhad, Iran.

Abstract

Introduction: Pesticide poisoning is common in Iran especially in rural communities. Amitraz is a formamidine compound that the prevalence of its poisoning is less common than organophosphate poisoning. In this study a case of pregnant women with brain edema due to amitraz poisoning is reported.
Case Presentation: A 15 years old female in 18th week of pregnancy was referred to Imam Reza hospital with history of deliberate consumption of about half a glass of liquid pesticide of amitraz, 5 hours before hospitalization. At first, she had nausea and vomiting then became confused in about an hour. Initial vital sign on arrival were: blood pressure: 90/60 mmHg, pulse rate 70, with Glasgow Coma Scale scores of 3/15. Both pupils were dilated and unresponsive to light. There was no evidence of trauma and no focal neurologic deficit signs. According to deep coma and moist mucous membranes, atropine and pralidoxime were prescribed assuming severe poisoning. Atropine and pralidoxime were discontinued when it became clear that was amitraz poisoning and treatment of cerebral edema was started due to cerebral edema was detected in brain CT-scan. Her consciousness gradually improved 3 days after admission. The patient was discharged after 3 days and 21 weeks later a healthy neonate was born by vaginal delivery.
Conclusion: Amitraz poisoning has no known antidote and the symptoms improve with treatment in most of cases.
 

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