JZUS - Journal of Zhejiang University SCIENCE

Journal of Zhejiang University SCIENCE B

Accepted manuscript available online (unedited version)

Seizure as the main presenting manifestation of three patients with acute glufosinate-ammonium poisoning

Author(s): Ping WANG, Congying SONG, Xuan LU, Yuanqiang LU
Affiliation(s): Department of Emergency Medicine, the First Affiliated Hospital, School of Medicine, Zhejiang University,Hangzhou310003,China; more
Corresponding email(s): luyuanqiang@zju.edu.cn
Key Words: Glufosinate-ammonium; Seizure; Herbicide intoxication; Head CT

Share this article to： More <<< Previous Paper \|Next Paper >>>

Ping WANG, Congying SONG, Xuan LU, Yuanqiang LU. Seizure as the main presenting manifestation of three patients with acute glufosinate-ammonium poisoning[J]. Journal of Zhejiang University Science B,in press.Frontiers of Information Technology & Electronic Engineering,in press.https://doi.org/10.1631/jzus.B2300469

@article{title="Seizure as the main presenting manifestation of three patients with acute glufosinate-ammonium poisoning",
author="Ping WANG, Congying SONG, Xuan LU, Yuanqiang LU",
journal="Journal of Zhejiang University Science B",
year="in press",
publisher="Zhejiang University Press & Springer",
doi="https://doi.org/10.1631/jzus.B2300469"
}

%0 Journal Article
%T Seizure as the main presenting manifestation of three patients with acute glufosinate-ammonium poisoning
%A Ping WANG
%A Congying SONG
%A Xuan LU
%A Yuanqiang LU
%J Journal of Zhejiang University SCIENCE B
%P 354-358
%@ 1673-1581
%D in press
%I Zhejiang University Press & Springer
doi="https://doi.org/10.1631/jzus.B2300469"

TY - JOUR
T1 - Seizure as the main presenting manifestation of three patients with acute glufosinate-ammonium poisoning
A1 - Ping WANG
A1 - Congying SONG
A1 - Xuan LU
A1 - Yuanqiang LU
J0 - Journal of Zhejiang University Science B
SP - 354
EP - 358
%@ 1673-1581
Y1 - in press
PB - Zhejiang University Press & Springer
ER -
doi="https://doi.org/10.1631/jzus.B2300469"

Abstract
Chinese Summary
Academic Network
Reviewer Comment

Abstract: Glufosinate-ammonium herbicides are the most widely used broad-spectrum, non-selective herbicides in the world. Glufosinate-ammonium is a structural analogue of glutamate (Glu) which can irreversibly inhibit the activity of glutamine synthetase (GS) and Glu decarboxylase in plants, thereby blocking the synthesis of glutamine (Gln) from Glu and ammonia (Hoerlein, 1994). This causes the plants to die because of the nitrogen metabolism disorder and subsequent intracellular accumulation of ammonia. In humans, the characteristic features of glufosinate-ammonium herbicide poisoning include gastrointestinal symptoms and neurotoxicity (Watanabe and Sano, 1998). Currently, there are no antidotes for glufosinate-ammonium herbicide poisoning, and thus supportive care is the key treatment.

三例以癫痫为主要表现的急性草铵膦中毒患者的病例报告

王萍^1,2，宋聪颖^1,2，陆璇^2,3，陆远强^1,2
¹浙江大学医学院附属第一医院急诊科，中国杭州市，310003
²浙江省增龄与理化损伤性疾病诊治研究重点实验室，中国杭州市，310003
³浙江大学医学院附属第一医院老年科，中国杭州市，310003
摘要：草铵膦作为谷氨酸（Glu）的结构类似物，可以不可逆地抑制植物中谷氨酰胺合成酶（GS）和谷氨酸脱羧酶活性，从而阻止谷氨酰胺（Gln）生成，最终导致植物因氮代谢紊乱和细胞内氨积累而死亡。人误服草胺磷后也会出现相应的中毒症状，包括胃肠道症状和神经毒性。草铵膦作为最常见的致癫痫类除草剂，且无特定解毒剂，因此支持性治疗至关重要。在临床诊治过程中，如何及时有效识别草铵膦除草剂引起的神经毒性并提供适当治疗尤为关键。本文介绍了我院三名草铵膦中毒患者的主要症状，其中癫痫是主要的神经表现。随后，通过查阅相关文献，对草铵膦引发神经毒性的相关机制进行了总结，并讨论了神经毒性的预测和检测方法。

关键词组：草铵膦；癫痫；除草剂中毒；头部CT

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[1]ChaYS,KimH,LeeY,et al.,2018.The relationship between serum ammonia level and neurologic complications in patients with acute glufosinate ammonium poisoning: a prospective observational study.Hum Exp Toxicol,37(6):571-579.

[2]HermenegildoC,MonfortP,FelipoV,2000.Activation ofN-methyl-D-aspartate receptors in rat brainin vivo following acute ammonia intoxication: characterization byin vivo brain microdialysis.Hepatology,31(3):709-715.

[3]HoerleinG,1994.Glufosinate (phosphinothricin), a natural amino acid with unexpected herbicidal properties. In: Ware GW (Ed.),Reviews of Environmental Contamination and Toxicology: Continuation of Residue Reviews.Springer,New York, p.73-145.

[4]HoriY,TanakaT,FujisawaM,et al.,2003.Toxicokinetics of DL-glufosinate enantiomer in human BASTA^® poisoning.Biol Pharm Bull,26(4):540-543.

[5]KimJ,ChunBJ,MoonJM,et al.,2022.Prognostic value of neutrophil to lymphocyte ratio in the diagnosis of neurotoxicity after glufosinate ammonium poisoning.J Toxicol Environ Health Part A,85(12):511-519.

[6]ParkS,KimDE,ParkSY,et al.,2018.Seizures in patients with acute pesticide intoxication, with a focus on glufosinate ammonium.Hum Exp Toxicol,37(4):331-337.

[7]ParkS,KimJI,ChoNJ,et al.,2020.Decreased glucose utilization contributes to memory impairment in patients with glufosinate ammonium intoxication.J Clin Med,9(4):1213.

[8]QinCF,YangYM,LuYQ,2023.Perforation of the esophagus: an overlooked cause of chest pain as a complication of esophageal foreign bodies.J Zhejiang Univ-Sci B (Biomed & Biotechnol),24(5):455-457.

[9]Rangroo ThraneV,ThraneAS,WangFS,et al.,2013.Ammonia triggers neuronal disinhibition and seizures by impairing astrocyte potassium buffering.Nat Med,19(12):1643-1648.

[10]SongCY,LuYQ,2022.A man with fever and cogwheel-like dermal lesions.Int Emerg Med,17(8):2423-2425.

[11]SongHY,KimYH,SeokSJ,et al.,2012.Cellular toxicity of surfactants used as herbicide additives.J Korean Med Sci,27(1):3-9.

[12]TongT,DuanWX,XuYD,et al.,2022.Paraquat exposure induces Parkinsonism by altering lipid profile and evoking neuroinflammation in the midbrain.Environ Int,169:107512.

[13]WangP,SongCY,LuYQ,2022.Isolated superior mesenteric artery rupture caused by abdominal trauma.J Zhejiang Univ-Sci B (Biomed & Biotechnol),23(12):1065-1068.

[14]WangZD,LuX,YangYM,et al.,2023.Inflammatory granuloma of the trachea: a rare case with Epstin-Barr virus infection.J Zhejiang Univ-Sci B (Biomed & Biotechnol),24(6):539-542.

[15]WatanabeT,SanoT,1998.Neurological effects of glufosinate poisoning with a brief review.Hum Exp Toxicol,17(1):35-39.

[16]ZhouX,HollernD,LiaoJ,et al.,2013.NMDA receptor-mediated excitotoxicity depends on the coactivation of synaptic and extrasynaptic receptors.Cell Death Dis,4(3):e560.

Open peer comments: Debate/Discuss/Question/Opinion

<1>

- Go to

三例以癫痫为主要表现的急性草铵膦中毒患者的病例报告

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference