A case of fatal chlorfenapyr poisoning: evidence from histopathology and autopsy.

IF 1.5 4区 医学 Q2 MEDICINE, LEGAL
Hinsan Chui, Qian Wei, Ying Wang, Jiahui Chen, Feijun Huang, Fenghua Zhang, Daoyin Gong
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Abstract

Chlorfenapyr poisoning is rare in clinical practice, with limited documented cases. This study aims to elucidate the clinical progression and pathological features of fatal chlorfenapyr poisoning through a forensic autopsy case. We present a case involving a 15-year-old male who died following oral ingestion of chlorfenapyr. Autopsy and histopathological examinations were performed, supplemented by toxicological analysis. Findings included decerebrate rigidity, cerebral edema, myocardial contraction band necrosis, pulmonary hemorrhage, and rhabdomyolysis. Histopathology confirmed neuronal damage, gliosis, and myoglobin-positive renal tubules. Toxicological analysis detected both chlorfenapyr and tralopyril in premortem and postmortem blood samples. Tralopyril levels measured 2610 ng/mL premortem and 1980 ng/mL postmortem, while chlorfenapyr levels were 320 ng/mL and 280 ng/mL, respectively. The patient exhibited delayed symptom onset, rapid deterioration, and resistance to supportive treatment. This case underscores chlorfenapyr's systemic toxicity, particularly its impact on high-energy-demand organs. The absence of a specific antidote highlights the need for early intervention and hemodialysis. This report-the first forensic autopsy of adolescent chlorfenapyr poisoning-enhances understanding of its pathophysiology and aids clinicians in recognizing nonspecific early symptoms.

致死性氯苯那韦中毒1例:来自组织病理学和尸检的证据。
氯虫那韦中毒在临床实践中是罕见的,有记录的病例有限。本研究旨在通过一个法医尸检案例,阐明致死性氯虫那韦中毒的临床进展和病理特征。我们提出一个病例,涉及一个15岁的男性谁死后口服摄入氯苯那韦。进行尸检和组织病理学检查,并辅以毒理学分析。结果包括失脑性强直、脑水肿、心肌收缩带坏死、肺出血和横纹肌溶解。组织病理学证实神经元损伤、神经胶质瘤和肌红蛋白阳性肾小管。毒理学分析在死前和死后的血液样本中检测到氯非那韦和曲洛吡利。死前和死后的曲洛吡里尔水平分别为2610 ng/mL和1980 ng/mL,而氯非那韦的水平分别为320 ng/mL和280 ng/mL。患者表现出症状发作延迟、病情迅速恶化和对支持治疗的抵抗。该病例强调了氯虫腈的全身性毒性,特别是其对高能量需求器官的影响。特异性解毒剂的缺乏突出了早期干预和血液透析的必要性。该报告是青少年氯虫那韦中毒的首次法医尸检,提高了对其病理生理学的理解,并帮助临床医生识别非特异性的早期症状。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Forensic Science, Medicine and Pathology
Forensic Science, Medicine and Pathology MEDICINE, LEGAL-PATHOLOGY
CiteScore
3.90
自引率
5.60%
发文量
114
审稿时长
6-12 weeks
期刊介绍: Forensic Science, Medicine and Pathology encompasses all aspects of modern day forensics, equally applying to children or adults, either living or the deceased. This includes forensic science, medicine, nursing, and pathology, as well as toxicology, human identification, mass disasters/mass war graves, profiling, imaging, policing, wound assessment, sexual assault, anthropology, archeology, forensic search, entomology, botany, biology, veterinary pathology, and DNA. Forensic Science, Medicine, and Pathology presents a balance of forensic research and reviews from around the world to reflect modern advances through peer-reviewed papers, short communications, meeting proceedings and case reports.
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