Characteristics of endosulfan poisoning: a study of 23 cases.

INTRODUCTION: Organochloride insecticides are chlorinated cyclic hydrocarbons having molecular weights in the range of 300-550 Da. Case series of endosulfan poisoning are extremely rare in the literature. We report 23 cases of endosulfan poisoning. METHODS: This retrospective study enrolled patients with endosulfan poisoning presenting to our emergency department from January to December 2005. The data were collected from clinical records and laboratory files. RESULTS: On admission, initial symptoms were nausea and vomiting in 17 patients (73.9 percent), seizures in five patients (21.7 percent), and dizziness in one patient (4.3 percent). Symptoms began within one hour after ingestion in 12 patients (52.2 percent), in the second hour in nine patients (39.1 percent), and in the third hour in two patients (8.7 percent). Seizure types were generalised tonic-clonic in 16 patients (84.2 percent), and focal seizures in three patients (15.8 percent). 19 patients were observed for one day, two patients were observed for two days, and one patient was followed-up for ten days in the emergency department. One patient was transferred for liver transplantation on the fifth day to another centre. All patients were treated symptomatically by intravenous diazepam for controlling seizures. CONCLUSION: Endosulfan poisoning can be suspected in the presence of primary central nervous system manifestations including seizures, with or without clinical or laboratory evidence of other organ dysfunction such as liver failure.