Dimethylacetamide, ethylenediamine, and diphenylmethane diisocyanate poisoning manifest as acute psychosis and pulmonary edema: treatment with hemoperfusion.
A 27-year-old man, employed by a synthetic fiber company, had been exposed to dimethylacetamide, ethylenediamine, and diphenylmethane diisocyanate in a confined space continuously for 4-6 hours per day for 3 days before admission. Hallucinations and delusions were noted at admission; pulmonary edema developed subsequently. The electroencephalogram showed diffuse moderate cortical dysfunction and slow waves at 4-7 Hz, 20-80 microV. Seizures, liver injury, and rhabdomyolysis were noted on the 4th hospital day. The patient was treated by hemoperfusion with a decrease in urine dimethylacetamide from 3,265 mg/g to 4 mg/g creatinine over 4 days. Serial urinary dimethylacetamide and electroencephalogram correlated with the clinical condition.
Su
T C
TC
National Taiwan University Hospital, Taipei.
Lin
P H
PH
Chiu
M J
MJ
Chu
T S
TS
Chang
M J
MJ
Wang
J D
JD
Cheng
T J
TJ
D000081:Acetamides / Q000506:poisoning* / Q000652:urine; D000328:Adult; D002606:Charcoal / Q000627:therapeutic use; D003702:Delusions / Q000139:chemically induced; D004569:Electroencephalography / Q000187:drug effects; D005029:Ethylenediamines / Q000506:poisoning*; D006212:Hallucinations / Q000139:chemically induced; D006464:Hemoperfusion; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects; D017953:Isocyanates / Q000506:poisoning*; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects; D011618:Psychotic Disorders / Q000209:etiology* / Q000628:therapy; D011654:Pulmonary Edema / Q000139:chemically induced* / Q000628:therapy; D012640:Seizures / Q000139:chemically induced; D012869:Skin Absorption; D012883:Skin Ulcer / Q000139:chemically induced; D016896:Treatment Outcome; D001559:Benzhydryl Compounds
D000081:Acetamides; D002606:Charcoal; D005029:Ethylenediamines; D017953:Isocyanates; C031234:ethylenediamine; C005969:4,4'-diphenylmethane diisocyanate; D001559:Benzhydryl Compounds; C013959:dimethylacetamide; C018595:N-methylacetamide