title: Tetramine poisoning: A case report and review of the literature.
abstract: BACKGROUND
  Tetramethylene disulfotetramine (TETS), a banned neurotoxic rodenticide, has accounted for numerous intentional and unintentional poisonings in mainland China. Since the first known case of human illness caused by tetramine occurred in NewYork, in May 2002, TETS has caused more than 50 human poisonings in Western countries.
  
  
  OBJECTIVE
  To analyze pathological changes of TETS poisoning and to provide evidence for forensic identification.
  
  
  METHODS
  We report the case of a 28-year-old female who suffered from tetramine poisoning and died of multi-organ failure. We also performed a retrospective study of 40 cases of poisoning, from pathological autopsy reports, by analyzing and summarizing the related the literature from 1996 to 2010. Based on pathologic autopsies and the literature, we summarize the pathological changes related to tetramine poisoning.
  
  
  RESULTS
  Signs of asphyxia were obvious upon pathological examination. Edema and congestion of organs, particularly in the brain, were seen in all cases. Subarachnoid and cerebral hemorrhaging were also common signs of tetramine poisoning.
  
  
  CONCLUSIONS
  In forensic practice, tetramine poisoning should be considered when the patient has signs of abnormal excitation of the central nervous system, convulsions, hyperspasmia, and cerebral hemorrhage.
authors.affiliation: Department of Pathology, Shantou University Medical College, Shantou, Guangdong 515031, PR China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
authors.forename: Min
authors.initials: M
authors.lastname: Su
authors.forename: Dong-Ping
authors.initials: DP
authors.lastname: Tian
mesh_terms: D000328:Adult; D001237:Asphyxia / Q000473:pathology; D001921:Brain / Q000473:pathology; D001952:Bridged-Ring Compounds / Q000506:poisoning*; D002543:Cerebral Hemorrhage / Q000473:pathology; D004487:Edema / Q000473:pathology; D005260:Female; D049429:Forensic Pathology; D053593:Forensic Toxicology; D006801:Humans; D007668:Kidney / Q000473:pathology; D008099:Liver / Q000473:pathology; D008168:Lung / Q000473:pathology; D009102:Multiple Organ Failure / Q000139:chemically induced; D009206:Myocardium / Q000473:pathology; D011041:Poisoning / Q000175:diagnosis; D012378:Rodenticides / Q000506:poisoning*; D013270:Stomach / Q000473:pathology; D013345:Subarachnoid Hemorrhage / Q000473:pathology
chemical_list: D001952:Bridged-Ring Compounds; D012378:Rodenticides; C010349:tetramethylenedisulfotetramine