Pharmacokinetic Potentiation of Mixed Organophosphate and Pyrethroid Poison Leading to Prolonged Delayed Neuropathy

• Main Authors: Meenakshi Srinivasan, Ruhul Amin, Girish Thunga, Shivashankar Kaniyoor Nagiri, Chandrashekar Udyavara Kudru
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2016-11-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: chlorpyrifos; cypermethrin; mixed poisoning
• Online Access: https://jcdr.net/articles/PDF/8773/22756_CE(RA1)_F(T)_PF1(AH_RK)_PFA(AK)_PF2(PAG).pdf

Organophosphate (OP) and mixed pesticide poisoning remains an important cause of hospital admission. Therefore, physician must be aware of atypical presentations of delayed neurological complications of poisoning by taking proper patient history. We report a case of a 23-year-old female who presented with high stepping gait and muscle wasting in hands. Patient history revealed consumption of approximately 4ml of mixed pesticide, consisting of 50% chlorpyrifos with synthetic pyrethroid, 5% cypermethrin. The prolonged and severe nature of delayed peripheral neuropathy, persisting at two years of follow-up, suggests that even small quantities of OP taken in combination with a pyrethroid can result in significant morbidity and is irreversible.