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The poisoning by the chloralose: Experience of the university hospital Hassan II of Fez between 2011 and 2014 - 13/01/18

Doi : 10.1016/j.toxac.2017.12.003 
Imane Iken a, b, , Hasnae Hoummani a, Ali Derkaoui c, Ibrahim Boukatta c, Samira Oulfakir d, Adnane Bardai c, Mustapha Harandou c, Mohammed Khatouf c, Nabil Kanjaa c, Sanae Achour a, b
a Laboratory of toxicology, central medical laboratory of analysis, university hospital center Hassan II of Fez, Fez, Morocco 
b Faculty of medicine and pharmacy, Fez, Morocco 
c Intensive care unit, university hospital center Hassan II of Fez, Fez, Morocco 
d Laboratory of epidemiology and public health, faculty of medicine and pharmacy of Fez, Fez, Morocco 

Corresponding author. Laboratory of toxicology, central medical laboratory of analysis, university hospital center Hassan II of Fez, Fez, Morocco.
Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le samedi 13 janvier 2018
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Summary

Introduction

The alphachloralose or chloralose is a dangerous rodenticide implied in a significant number of accidental or voluntary poisonings. The acute poisoning by the alphachloralose is frequent, appears at a dose of 1g for adults and 20mg/kg for children. The neurological signs dominate the clinical picture usually associating a driving hyperexcitability with myoclonus characteristics and a coma of variable depth according to the ingested dose.

Objectives

To estimate the demographic, clinical, analytical and therapeutic characteristics of the cases of poisoning by the alphachloralose received in the laboratory of toxicology of the hospital center Hassan II of Fez.

Patients and methods

It is about a retrospective study led between May 2011 and December 2015, which concerned cases of acute poisoning with alphachloralose. The study was carried out in the toxicology laboratory of the University of Hassan II Hospital Centre in Fez city. We have included all confirmed cases of alphachloralose poisoning regardless of age, sex, provenance and circumstance of intoxication. The confirmation was made by toxicological analysis with Fujiwara-Ross.

Results

During the study period, one hundred and two cases of suspicion of acute poisoning by alphachloralosis were recorded, accounting for 12.7% (102/798) of all laboratory-testing requests received; of which 39 cases were analyzed. The average age was 20.4±7.1 with extremes of age going from 3 years to 38 years; the sex ratio was 2.9 with a net feminine ascendancy. The circumstances of poisoning were generally suicidal in adults in 69.2% of the cases (27/39); four cases of pediatric poisonings were voluntary. The neurological signs of appeal were the most frequent symptoms (66.8% of the sick), with characteristic myoclonus in 12.5% of cases, pupils were mydriasis to 9.4% of the cases (28/39) and 9.38% of the cases (28/39) presented a bronchial congestion. The symptomatic treatment was realized in 94.1% of the cases. The evolution was favorable in all of the cases.

Conclusion

In spite of a rich neurological picture with quasi-constant presence of a coma, the forecast of the acute poisoning by the alphachloralose remains favorable under early and adequate symptomatic treatment.

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Keywords : Poisoning, Chloralose, Rodenticide


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© 2017  Société Française de Toxicologie Analytique. Publié par Elsevier Masson SAS. Tous droits réservés.
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