US EPA

7442140 

Journal Article 

Amitraz: a mimicker of organophosphate poisoning 

Dhooria, S; Behera, D; Agarwal, R 

2015 

1 

BMJ Case Reports
EISSN: 1757-790X 

BMJ Publishing Group 

2015 

English 

26430228 

10.1136/bcr-2015-210296 

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. 

alanine aminotransferase; alkaline phosphatase; amitraz; aspartate aminotransferase; atropine; carbamic acid; cholinesterase; dopamine; glucose; heparin; lactate dehydrogenase; noradrenalin; opiate; organochlorine derivative; organophosphate pesticide; pantoprazole; pralidoxime; sodium; amitraz; cholinergic receptor blocking agent; cholinesterase reactivator; toluidine derivative; adult; alkaline phosphatase blood level; Article; artificial ventilation; aspartate aminotransferase blood level; blood pressure; breathing rate; case report; differential diagnosis; drowsiness; Glasgow coma scale; glucose blood level; human; hyperglycemia; hypernatremia; hypothermia; hypoxemia; intensive care unit; intoxication; intubation; laboratory test; lactate dehydrogenase blood level; length of stay; male; metabolic acidosis; priority journal; pulse rate; pupil reflex; respiratory acidosis; sodium blood level; suicide attempt; T wave inversion; treatment duration; young adult; blood; bradycardia; chemically induced; diagnostic error; follow up; hyperglycemia; hypotension; miosis; organophosphate poisoning; suicide attempt; treatment outcome; Atropine; Bradycardia; Cholinesterase Reactivators; Diagnosis, Differential; Diagnostic Errors; Follow-Up Studies; Humans; Hyperglycemia; Hypotension; Male; Miosis; Organophosphate Poisoning; Parasympatholytics; Pralidoxime Compounds; Suicide, Attempted; Toluidines; Treatment Outcome; Young Adult