title: Clinical and pharmacological profile in a clenbuterol epidemic poisoning of contaminated beef meat in Italy.
abstract: Long-acting beta adrenergic agonists, such as clenbuterol accumulate in the liver, but not meat of treated farm animals, and result in epidemic poisonings in consumers. We describe an outbreak of poisoning in 15 people, following the consumption of meat. Clinical symptoms (distal tremors, palpitations, headache, tachipnoea-dyspnoea, and also moderate hyperglycaemia, hypokalemia and leucocytosis) were seen in nine hospitalised patients, starting about 0.5-3 h after poisoning, and disappearing within 3-5 days later. Clenbuterol was found in the urine of all the symptomatic patients, at higher levels than pharmacokinetic computing (mean level 28 ng/ml, 36 h after ingestion), based on the levels found in the meat (1140-1480 ng/g edible tissue). Thus, epidemic poisoning can be produced following the consumption of contaminated meat. The need for a better definition of pharmaco- and toxico-kinetics, not only for drugs ingested as parent drug, but also when ingested as residues with animal tissues, is recommended.
authors.affiliation: Istituto Superiore di Sanità, viale Regina Elena, 299, 00161, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Brambilla
authors.forename: T
authors.initials: T
authors.lastname: Cenci
authors.forename: F
authors.initials: F
authors.lastname: Franconi
authors.forename: R
authors.initials: R
authors.lastname: Galarini
authors.forename: A
authors.initials: A
authors.lastname: Macrì
authors.forename: F
authors.initials: F
authors.lastname: Rondoni
authors.forename: M
authors.initials: M
authors.lastname: Strozzi
authors.forename: A
authors.initials: A
authors.lastname: Loizzo
mesh_terms: D000318:Adrenergic beta-Agonists / Q000506:poisoning*; D000328:Adult; D000818:Animals; D002417:Cattle; D002976:Clenbuterol / Q000506:poisoning* / Q000652:urine; D004196:Disease Outbreaks; D004890:Erythema / Q000139:chemically induced; D005260:Female; D005517:Foodborne Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy / Q000652:urine; D006261:Headache / Q000139:chemically induced; D006801:Humans; D007262:Infusions, Intravenous; D007558:Italy / Q000453:epidemiology; D007964:Leukocytosis / Q000139:chemically induced; D008297:Male; D008460:Meat / Q000032:analysis / Q000506:poisoning*; D008659:Metabolic Diseases / Q000139:chemically induced; D009120:Muscle Cramp / Q000139:chemically induced; D009325:Nausea / Q000139:chemically induced; D009422:Nervous System Diseases / Q000139:chemically induced; D012965:Sodium Chloride / Q000008:administration & dosage; D013610:Tachycardia / Q000139:chemically induced; D016896:Treatment Outcome
chemical_list: D000318:Adrenergic beta-Agonists; D012965:Sodium Chloride; D002976:Clenbuterol