salicylates and Mushroom-Poisoning

Topics: Age Factors; Amphetamine; Amphetamines; Atropine Derivatives; Barbiturates; Charcoal; Child; Child, Preschool; Gastric Lavage; Humans; Imipramine; Infant; Ipecac; Mushroom Poisoning; Opium; Organophosphate Poisoning; Phenothiazines; Poisoning; Poisons; Salicylates; Tranquilizing Agents

Toxic induced hypoglycemia is usually caused by the anti-diabetic treatment and excessive alcohol consume. Hypoglycemia in diabetics treated with insulin or anti-diabetic oral agents is far the most studied form of hypoglycemia. Less information is available on toxic-induced hypoglycemia in non-diabetic subjects with acute exogenous poisoning.. We retrospectively studied adult non-diabetic patients admitted in Emergency Clinic Hospital of Iaşi with hypoglycemia caused by an acute poisoning, over a period of 10 years. Then we performed a prospective study in those poisoning associated with hypoglycemic risk, to assess the prevalence of toxic-induced hypoglycemia.. We identified 15,497 patients with acute poisoning in our retrospective study, 4,005 of whom presented poisoning associated with hypoglycemic risk (40% acute ethanol poisoning, 29% wild mushroom poisoning, 23% beta-blocker poisoning, 7% salicylate poisoning and 1% patients with anti-diabetic agents acute poisoning). The prospective study identified 1,034 patients with acute poisoning, 20.11% of whom had ethanol poisoning, 11.79% had beta-blocker poisoning, 5.89% had wild mushroom poisoning, 1.74% had salicylate poisoning and the rest of 60.47% had other acute poisoning, without hypoglycemic risk. Attempted suicide with anti-diabetic agents in non-diabetic subjects produced the most severe and prolonged form of hypoglycemia in acute poisoning. 23 patients in retrospective study and 6 patients in prospective study died, but in only one situation, the death was the direct consequence of hypoglycemia.. In non-diabetic subjects with acute poisoning, prevalence of toxic-induced hypoglycemia depends on the poison itself, the mechanism of poisoning, also depends on the association between toxics and the severity of toxic- induced liver disease. A useful test to assess toxic-induced hypoglycemia is standard 6 hour oral glucose tolerance test (OGTT). Factors predicting a negative outcome in toxic-induced hypoglycemia are association of toxins, cardiac and hepatic complications, and age (>65 years).

Topics: Adolescent; Adrenergic beta-Antagonists; Adult; Age Factors; Aged; Alcohol Drinking; Blood Glucose; Cyclooxygenase Inhibitors; Female; Glucose Tolerance Test; Humans; Hypoglycemia; Hypoglycemic Agents; Male; Middle Aged; Mushroom Poisoning; Prospective Studies; Retrospective Studies; Romania; Rural Health; Salicylates; Urban Health