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Rodenticide ingestion is an important cause of acute hepatotoxicity in Tamil Nadu, southern India.
- Source :
-
Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology [Indian J Gastroenterol] 2021 Aug; Vol. 40 (4), pp. 373-379. Date of Electronic Publication: 2021 Jun 30. - Publication Year :
- 2021
-
Abstract
- Background and Aim: Though rodenticidal hepatotoxicity is reported from India, there is no systematic study to assess its magnitude. This study aimed to assess exposure to rodenticide as a risk factor for acute hepatotoxicity in Tamil Nadu, India.<br />Methods: We retrospectively analyzed acute hepatotoxicity caused by ingestion of hepatotoxin or potentially hepatotoxic drug overdose across 15 hospitals in 6 districts of Tamil Nadu from 1 January 2019 to 30 June 2019. Study exclusion criteria were idiosyncratic drug-induced liver injury and chronic liver diseases.<br />Results: Of the 702 patients, 685 gave history of consuming rodenticide; hepatotoxicity in the other patients resulted from paracetamol overdose (n=10) and due to other drugs (n=7); 97% patients had a suicidal intent. Of 671 patients with complete data, ratio of number of patients with hepatotoxicity due to rodenticide to paracetamol overdose was 450:6 (i.e. 75:1). The 451 rodenticidal hepatotoxicity patients (255 males, 75% were 15-34 years old) underwent conservative management (n=396), plasma exchange (n=54) and plasma exchange followed by liver transplant (n=1); 159 patients (35%) had poor outcome (131 died, 28 discharged in moribund state). Based on our observations, we estimate a case burden of 1584 rodenticidal hepatotoxicity patients (95% CI: 265-6119) with poor outcome in 554 patients in Tamil Nadu from January 2019 to June 2019. Population attributable risk for rodenticide as cause of hepatotoxicity was 22.7%.<br />Conclusion: Rodenticide ingestion was an important cause of acute hepatotoxicity in Tamil Nadu. Most patients were young and one-third had poor outcome. Public health interventions are needed to address this.<br /> (© 2021. Indian Society of Gastroenterology.)
- Subjects :
- Adolescent
Adult
Chemical and Drug Induced Liver Injury etiology
Chemical and Drug Induced Liver Injury therapy
Drug Overdose drug therapy
Drug Overdose epidemiology
Female
Humans
India epidemiology
Liver Failure epidemiology
Liver Failure, Acute diagnosis
Liver Failure, Acute epidemiology
Liver Failure, Acute therapy
Liver Transplantation
Male
Retrospective Studies
Rodenticides toxicity
Young Adult
Acetaminophen adverse effects
Chemical and Drug Induced Liver Injury epidemiology
Liver Failure chemically induced
Liver Failure, Acute chemically induced
Rodenticides administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 0975-0711
- Volume :
- 40
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 34189713
- Full Text :
- https://doi.org/10.1007/s12664-021-01178-4