title: Amitraz: a mimicker of organophosphate poisoning.
abstract: Amitraz is used as an ectoparasiticide for dogs and cattle. Human poisoning due to amitraz may be misdiagnosed as organophosphate/carbamate (OPC) toxicity, since amitraz poisoning shares several clinical features (miosis, bradycardia and hypotension) encountered with OPC poisoning. A 19-year-old man with an alleged history of suicidal ingestion of a pesticide presented with drowsiness and was found to have constricted pupils, hypotension and bradycardia. He was diagnosed as a case of OPC poisoning and was treated with atropine and pralidoxime prior to presentation to our centre. Absence of a hypersecretory state, and the presence of hyperglycaemia and hypothermia along with a normal serum cholinesterase level suggested an alternate possibility. Retrieval of the poison container confirmed the diagnosis of amitraz poisoning. The patient made a rapid recovery with supportive management. Clinician awareness is key to successful management of this poisoning, which carries a good prognosis.
authors.affiliation: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sahajal
authors.initials: S
authors.lastname: Dhooria
authors.affiliation: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Digambar
authors.initials: D
authors.lastname: Behera
authors.affiliation: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Ritesh
authors.initials: R
authors.lastname: Agarwal
mesh_terms: D001285:Atropine / Q000627:therapeutic use; D001919:Bradycardia / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy; D002801:Cholinesterase Reactivators / Q000627:therapeutic use; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005500:Follow-Up Studies; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy; D007022:Hypotension / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D015877:Miosis / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy; D062025:Organophosphate Poisoning / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D010276:Parasympatholytics / Q000627:therapeutic use; D011220:Pralidoxime Compounds / Q000627:therapeutic use; D013406:Suicide, Attempted; D014052:Toluidines / Q000506:poisoning*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002801:Cholinesterase Reactivators; D010276:Parasympatholytics; D011220:Pralidoxime Compounds; D014052:Toluidines; C014983:amitraz; D001285:Atropine; C028797:pralidoxime