title: The effect of hemoperfusion on patients with toxic encephalopathy induced by silkworm chrysalis ingestion.
abstract: This study aims to determine therapeutic effect of hemoperfusion on patients with acute toxic encephalopathy induced by silkworm chrysalis ingestion. Three patients who developed toxic encephalopathy after chrysalis ingestion were analysed. Two patients lost their consciousness, while two patients had typical extrapyramidal tremor symptoms. Further neurological examination revealed various degrees of muscle strength impairment in these patients. All of them received treatments of omeprazole (40 mg/day), furosemide (one dose of 20 mg), vitamin C (2.0 g/day), calcium gluconate (2.0 g/day) and rehydration with glucose and sodium chloride (1500 ml/day). In addition, they received hemoperfusion treatment for 1.5 h. All patients recovered well after hemoperfusion. Two patients with loss of consciousness significantly recovered at 45 min and 65 min after hemoperfusion, respectively. All tremor symptoms were completely resolved in these patients at 30 min, 50 min, and 70 min following treatment, respectively. After the hemoperfusion treatment, encephalopathy symptoms of two patients had completely disappeared. All patients were followed up for one month and did not report any abnormalities. Our study indicates that hemoperfusion could be a useful and efficient treatment strategy for patients with acute encephalopathy after silkworm chrysalis ingestion. Larger clinical trials with longer follow-up are warranted to confirm the clinical benefit of hemoperfusion.
authors.affiliation: Attending doctor, Department of Emergency Medicine, The First Affiliated Hospital of Jilin University, China.
authors.forename: Haixia
authors.initials: H
authors.lastname: Hu
authors.affiliation: Attending doctor, Department of Neurology, The First Affiliated Hospital of Jilin University, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Wang
authors.affiliation: Resident physician, Department of Emergency Medicine, The First Affiliated Hospital of Jilin University, China.
authors.forename: Jiaqi
authors.initials: J
authors.lastname: Lv
authors.affiliation: Resident physician, Department of Emergency Medicine, The First Affiliated Hospital of Jilin University, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Sun
authors.affiliation: Professor, Department of Emergency Medicine, The First Affiliated Hospital of Jilin University, China 152037824@qq.com haixiahu1981@163.com.
authors.forename: Jihong
authors.initials: J
authors.lastname: Xing
authors.affiliation: Professor, Department of Emergency Medicine, The First Affiliated Hospital of Jilin University, China.
authors.forename: Xiaoliang
authors.initials: X
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D012831:Bombyx; D002125:Calcium Gluconate / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use*; D004435:Eating; D005260:Female; D005440:Fluid Therapy / Q000379:methods; D005517:Foodborne Diseases / Q000150:complications*; D005665:Furosemide / Q000627:therapeutic use*; D006464:Hemoperfusion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020258:Neurotoxicity Syndromes / Q000209:etiology* / Q000628:therapy; D009853:Omeprazole / Q000627:therapeutic use*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D011679:Pupa / Q000648:ultrastructure; D016896:Treatment Outcome
chemical_list: D004232:Diuretics; D054328:Proton Pump Inhibitors; D005665:Furosemide; D009853:Omeprazole; D002125:Calcium Gluconate
keywords: Chrysalis poisoning; hemoperfusion; poisoning encephalopathy