PDF(Pubmed)
Abstract：
Indoxacarb, an oxadiazine insecticide, is known for its selective lethality by blocking neuronal voltage-dependent sodium channels. While primarily developed to target insect populations resistant to other pesticides, its toxicity in humans remains poorly understood. We present a case of methemoglobinemia resulting from indoxacarb ingestion, a rare manifestation of its toxic effects. A 38-year-old farmer attempted suicide by ingesting the insecticide, leading to cyanosis, hypoxemia, and characteristic arterial blood gas findings indicative of methemoglobinemia. Prompt diagnosis was challenging due to the absence of specific tests, necessitating clinical suspicion. Treatment with methylene blue and supportive therapy resulted in significant clinical improvement, highlighting the importance of early intervention in managing indoxacarb poisoning. This case underscores the need for increased awareness among healthcare providers regarding the potential toxic effects of indoxacarb. It emphasizes the importance of prompt recognition and treatment of methemoglobinemia in pesticide-related poisonings. Further research is warranted to elucidate the mechanisms underlying indoxacarb toxicity in humans and to optimize treatment strategies for affected individuals.
摘要：
Indoxacarb,恶二嗪杀虫剂,已知其通过阻断神经元电压依赖性钠通道的选择性致死性。虽然主要针对对其他农药具有抗性的昆虫种群，它对人类的毒性仍然知之甚少。我们介绍了一例因摄入吲哚沙卡威而导致的高铁血红蛋白血症，其毒性作用的罕见表现。一名38岁的农民试图通过摄入杀虫剂自杀，导致紫癜,低氧血症,和特征性动脉血气发现表明高铁血红蛋白血症。由于缺乏特定的测试，及时诊断具有挑战性，需要临床怀疑。亚甲蓝治疗和支持治疗导致显著的临床改善，强调早期干预在处理吲哚沙卡中的重要性。该病例强调了医疗保健提供者需要提高对吲哚沙卡的潜在毒性作用的认识。它强调了在与农药相关的中毒中迅速识别和治疗高铁血红蛋白血症的重要性。需要进一步的研究来阐明吲哚沙卡在人类中的潜在毒性机制，并优化受影响个体的治疗策略。
