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Am J Emerg Med. 2019 Apr 24. pii: S0735-6757(19)30267-0. doi: 10.1016/j.ajem.2019.04.042. [Epub ahead of print]

Serial measurement of glyphosate blood concentration in a glyphosate potassium herbicide-intoxicated patient: A case report.

Author information

1
Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, South Korea.
2
Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, South Korea. Electronic address: gardenjun@hanmail.net.
3
Forensic Toxicology Division, National Forensic Service, Wonju, Kangwon Province, South Korea.
4
Department of Emergency Medicine, Konyang University Hospital, Daejeon, South Korea.

Abstract

INTRODUCTION:

This report describes changes in blood and urine concentrations of glyphosate potassium over time and their correlations with clinical symptoms in a patient with acute glyphosate potassium poisoning.

CASE REPORT:

A 67-year-old man visited the emergency center after ingesting 250 mL of a glyphosate potassium-based herbicide 5 h before. He was alert but presented with nausea, vomiting, and bradyarrhythmia with atrial fibrillation (tall T waves). Laboratory findings revealed a serum potassium level of 6.52 mEq/L. After treatment with an injection of calcium gluconate, insulin with glucose, bicarbonate, and an enema with polystyrene sulfonate, the patient's serum potassium level normalized and the bradyarrhythmia converted to a normal sinus rhythm. During admission, the blood and urine concentration of glyphosate and urine aminomethylphosphonic acid (AMPA, a glyphosate metabolite) was measured at regular time intervals. The patient's glyphosate blood concentration on admission was 11.48 mg/L, and it had decreased rapidly by 16 h and maintained about 1mgl/L by 70 h after admission. Urine glyphosate and AMPA levels had also decreased rapidly by 6 h after admission.

DISCUSSION:

Glyphosate potassium poisoning causes hyperkalemia. Blood concentrations of glyphosate were decreased rapidly by 16 h after admission, and urine concentrations were also decreased by 6 h after admission.

KEYWORDS:

Glyphosate; Herbicides; Hyperkalemia; Toxicokinetics

PMID:
31053371
DOI:
10.1016/j.ajem.2019.04.042

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