title: Rhabdomyolysis, acute renal failure, and death after monensin ingestion.
abstract: We report a case of human monensin intoxication; to our knowledge, this is the first reported case in the medical literature. The patient took a dose of monensin three times higher than a dose considered lethal for cattle and developed a clinical picture similar to that reported in veterinary medicine. There was an early and extremely severe rhabdomyolysis followed by acute renal failure, heart failure, and death. The main changes observed at autopsy were extensive skeletal muscle necrosis, complement deposition at the myocardial level, pulmonary edema, and acute tubular damage.
authors.affiliation: Division of Nephrology, Intensive Care Unit, Service of Toxicology, and Department of Pathology, Hospital de Base, São José do Rio Preto Medical School, São José do Rio Preto, SP, Brazil.
authors.forename: C
authors.initials: C
authors.lastname: Caldeira
authors.forename: W S
authors.initials: WS
authors.lastname: Neves
authors.forename: P M
authors.initials: PM
authors.lastname: Cury
authors.forename: P
authors.initials: P
authors.lastname: Serrano
authors.forename: M A
authors.initials: MA
authors.lastname: Baptista
authors.forename: E A
authors.initials: EA
authors.lastname: Burdmann
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000473:pathology; D000293:Adolescent; D003186:Complement C9 / Q000032:analysis; D017809:Fatal Outcome; D006801:Humans; D007150:Immunohistochemistry; D007476:Ionophores / Q000009:adverse effects*; D007668:Kidney / Q000737:chemistry / Q000187:drug effects / Q000473:pathology; D008297:Male; D008985:Monensin / Q000009:adverse effects*; D018482:Muscle, Skeletal / Q000187:drug effects / Q000473:pathology; D009206:Myocardium / Q000737:chemistry / Q000473:pathology; D009211:Myoglobin / Q000032:analysis; D012206:Rhabdomyolysis / Q000139:chemically induced* / Q000473:pathology
chemical_list: D003186:Complement C9; D007476:Ionophores; D009211:Myoglobin; D008985:Monensin