Herbicide: fatal ammonium thiocyanate and aminotriazole poisoning.
OBJECTIVE
To describe fatal herbicide poisoning with Radoxone TL composed of aminotriazole and ammonium thiocyanate.


METHODS
A 54-year-old man was hospitalized because of unexplained coma with myoclonic jerks and vascular collapse. Despite symptomatic treatment with mechanical ventilation and vascular filling, life-threatening shock occurred with oliguria, profound metabolic acidosis and cardiac arrest. Hyperchloremia (141 mmol/L) with reversed anion gap (-19) suggested interference with chloride measurement caused by halogens (Br,F,I) or other anions such as thiocyanate. Eventually a weed killer, Radoxone TL containing ammonium thiocyanate, was found at the patient's house. Thiocyanate and aminotriazole blood levels were 750 mg/L and 138 mg/L respectively more than 12 hours after ingestion. After prolonged cardiopulmonary resuscitation, continuous venovenous hemodiafiltration was performed. Despite hemodynamic recovery the patient died 48 hours later of postanoxic coma.


CONCLUSIONS
Aminotriazole, a systemic nonselective herbicide, is often associated with ammonium thiocyanate which enhances its activity. Experimental studies and previous fatal cases suggest a predominant toxicity of thiocyanate. Early diagnosis is important.
Legras
A
A
Service de Réanimation médicale, Hôpital Bretonneau, Tours, France.
Skrobala
D
D
Furet
Y
Y
Kintz
P
P
Forveille
E
E
Dequin
P F
PF
Perrotin
D
D
D000640:Amitrole / Q000032:analysis / Q000506:poisoning*; D001826:Body Fluids / Q000737:chemistry; D017809:Fatal Outcome; D017583:Hemodiafiltration / Q000379:methods; D006540:Herbicides / Q000506:poisoning*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013861:Thiocyanates / Q000097:blood
D006540:Herbicides; D013861:Thiocyanates; C031760:thiocyanate; D000640:Amitrole