RESUMEN
To describe the optical coherence tomography (OCT) and electrophysiological changes in a case of closantel toxicity. A 25-year-old patient presented with sudden painless defective vision following intake of closantel. Visual acuity (VA) was counting fingers at 5 m in both eyes (BE). OCT revealed disruption of outer retinal layers and electroretinogram (ERG) and visual evoked potential (VEP) were subnormal in BE. The patient was treated with systemic corticosteroids, after which his VA improved to 6/9, OCT revealed preservation of central outer retinal layers, and ERG and VEP responses improved in BE. This is the first case report of successful treatment with systemic steroids for closantel-related reversible blindness.
Asunto(s)
Ceguera/inducido químicamente , Retina/patología , Salicilanilidas/envenenamiento , Agudeza Visual , Adulto , Ceguera/diagnóstico , Ceguera/fisiopatología , Angiografía con Fluoresceína , Fondo de Ojo , Humanos , Insecticidas/envenenamiento , Ionóforos , Masculino , Remisión Espontánea , Retina/efectos de los fármacos , Tomografía de Coherencia ÓpticaAsunto(s)
Antihelmínticos/envenenamiento , Ojo/efectos de los fármacos , Salicilanilidas/envenenamiento , Adulto , Electrorretinografía , Potenciales Evocados Visuales/efectos de los fármacos , Ojo/fisiopatología , Femenino , Humanos , Retina/efectos de los fármacos , Retina/patología , Agudeza Visual/efectos de los fármacos , Campos Visuales/efectos de los fármacos , Adulto JovenRESUMEN
BACKGROUND: Closantel is a halogenated salicylanilide with a potent anti parasitic activity. It is widely used in management of parasitic infestation in animals, but is contraindicated in humans. CASE PRESENTATION: A 34-year-old man with depression was referred to our center with progressive loss of vision in both eyes 10 days after unintentional ingestion of three 500 mg tablets of Closantel. On fundus examination, left optic disc margin was blurred. His bilateral visual acuity was no light perception (NLP) despite prescribed IV erythropoietin injections 20,000 units daily for 3 days and 1gr intravenous methylprednisolone acetate for 3 days followed by 1 mg/kg oral prednisolone. On macular optical coherence tomography (OCT), a disruption in outer retina was observed. Electroretinogram and visual evoked potential tests showed visual pathway involvement. CONCLUSIONS: Destruction of neurosensory retina and visual pathways after accidental Closantel use is related to severe visual loss. This case alerts us about the destructive effect of this drug on humans even in low dosage which necessitates preventive efforts to reduce the chance of this morbid side effect.
Asunto(s)
Antihelmínticos/envenenamiento , Enfermedades de la Retina/inducido químicamente , Salicilanilidas/envenenamiento , Trastornos de la Visión/inducido químicamente , Adulto , Humanos , Masculino , Drogas Veterinarias/envenenamientoAsunto(s)
Acetaldehído/análogos & derivados , Enfermedades de los Bovinos/inducido químicamente , Moluscocidas/envenenamiento , Salicilanilidas/envenenamiento , Vigilancia de Guardia/veterinaria , Enfermedades de las Ovejas/inducido químicamente , Acetaldehído/envenenamiento , Enfermedades de los Animales/epidemiología , Animales , Bovinos , Enfermedades de los Bovinos/epidemiología , Patos , Escocia , Ovinos , Enfermedades de las Ovejas/epidemiología , Especificidad de la Especie , Reino Unido/epidemiologíaRESUMEN
Toxicity of closantel, a halogenated salicylanilide anthelmintic, is described in 11 sheep and a goat, humanely killed 4-70 days after accidental overdosage. Status spongiosis of the cerebrum and cerebellum was present, its severity decreasing with time after treatment. Ultrastructurally, vacuoles in the cerebral white matter were seen to be intramyelinic due to splitting of myelin lamellae at the intraperiod lines, indicating myelin oedema. In the optic nerves, Wallerian degeneration and eventual fibrosis and atrophy of the nerves followed myelin vacuolation. Lesions in the optic nerves were particularly advanced in the intracanalicular portion, indicating a compressive neuropathy within the optic canal. Acute retinal lesions consisted of papilloedema, necrosis of the outer retinal layers (especially the photoreceptor layer), and retinal separation in tapetal and non-tapetal areas. In more chronic cases, the outer nuclear layer was diffusely attenuated and generally reduced to a single row of cells.
Asunto(s)
Antihelmínticos/envenenamiento , Enfermedades de las Cabras/inducido químicamente , Vaina de Mielina/ultraestructura , Enfermedades del Nervio Óptico/veterinaria , Degeneración Retiniana/veterinaria , Salicilanilidas/envenenamiento , Enfermedades de las Ovejas/inducido químicamente , Vacuolas/ultraestructura , Animales , Cerebelo/efectos de los fármacos , Cerebelo/patología , Sobredosis de Droga/veterinaria , Enfermedades de las Cabras/patología , Cabras , Microscopía Electrónica de Transmisión/veterinaria , Enfermedades del Nervio Óptico/inducido químicamente , Enfermedades del Nervio Óptico/patología , Degeneración Retiniana/inducido químicamente , Degeneración Retiniana/patología , Ovinos , Enfermedades de las Ovejas/patología , Telencéfalo/efectos de los fármacos , Telencéfalo/patologíaAsunto(s)
Antihelmínticos/envenenamiento , Enfermedades de las Cabras/inducido químicamente , Hepatopatías/veterinaria , Hígado/patología , Salicilanilidas/envenenamiento , Animales , Sistema Nervioso Central/patología , Enfermedad Hepática Inducida por Sustancias y Drogas , Sobredosis de Droga/patología , Sobredosis de Droga/veterinaria , Enfermedades de las Cabras/diagnóstico , Enfermedades de las Cabras/patología , Cabras , Hepatopatías/diagnóstico , Urinálisis/veterinariaAsunto(s)
Ceguera/veterinaria , Insecticidas/envenenamiento , Salicilanilidas/envenenamiento , Enfermedades de las Ovejas/inducido químicamente , Animales , Animales Recién Nacidos , Ceguera/inducido químicamente , Ceguera/patología , Dípteros/parasitología , Sobredosis de Droga/veterinaria , Hemoncosis/prevención & control , Hemoncosis/veterinaria , Ovinos , Enfermedades de las Ovejas/parasitología , Enfermedades de las Ovejas/patologíaRESUMEN
This report describes clinical and pathological findings in 2 flocks in Brazil where blindness and deaths in sheep occurred after closantel overdosage. Depression, weakness, and blindness affected 37 animals and 17 died in 2 flocks of 190 animals. Two animals submitted for ophthalmic examination showed no inflammation in the anterior segment of both eyes; posterior segment evaluation by indirect ophthalmoscopy suggested retinal degeneration. One postmortem evaluation local spongy vacuolization was in several regions of the brain and the optical nerves had severe axonal degeneration.