J Korean Soc Emerg Med.  2017 Oct;28(5):467-474. 10.0000/jksem.2017.28.5.467.

Prognosis of Acute Pancreatitis in Glyphosate Surfactant Herbicide-intoxicated Patients

• Song I
• Cha SY
• Kang MJ
• Kim YH
• Lee JH
• Cho KW
• Hwang SY
• Lee DW

• KMID: 2394395
• DOI: http://doi.org/10.0000/jksem.2017.28.5.467

Abstract

PURPOSE
Glyphosate herbicides (GHs) are widely used and increasingly associated with poisoning cases. Acute pancreatitis (AP) is among the many complications associated with the toxicity of GHs. We investigated the relationship between incidence of AP and its prognosis in patients with GH poisoning.
METHODS
This was a retrospective cohort study conducted at a single tertiary hospital between January 2004 and December 2014. We enrolled all patients presented to the emergency department with GH poisoning. The Clinical and laboratory variables were analyzed to investigate the relationship between GH intoxication and AP.
RESULTS
We studied 245 patients. Incidence of AP after GH poisoning was 6.5%. Patients with AP (mean 66 years) were older than the non-AP group (56 years). Systolic blood pressure, Glasgow Coma Scale, and amount of ingested poison differed significantly between the two groups. In the blood tests, white blood cell count, alanine aminotransferase, glucose, potassium, amylase, and lipase showed significant differences. The pH, bicarbonate, and lactate levels also differed significantly. Patients with AP demonstrated higher incidence of respiratory failure, pneumonia, acute kidney injury, rhabdomyolysis, and intensive care unit stay time. Additionally, 30-day mortality (n=11, 68.8%) was significantly higher in the AP group. On multivariate analysis, adjusted age, amount of ingestion, and lactate correlated with occurrence of AP.
CONCLUSION
The incidence of GH-induced AP was 6.5% with a 30-day mortality of 68.8%. The patient's age, ingested dosage, and lactate levels were associated with GH-induced AP.

Keyword

Glyphosate; Pancreatitis; Poisoning; Lipase; Prognosis

MeSH Terms

Acute Kidney Injury
Alanine Transaminase
Amylases
Blood Pressure
Cohort Studies
Eating
Emergency Service, Hospital
Glasgow Coma Scale
Glucose
Hematologic Tests
Herbicides
Humans
Hydrogen-Ion Concentration
Incidence
Intensive Care Units
Lactic Acid
Leukocyte Count
Lipase
Mortality
Multivariate Analysis
Pancreatitis*
Pneumonia
Poisoning
Potassium
Prognosis*
Respiratory Insufficiency
Retrospective Studies
Rhabdomyolysis
Tertiary Care Centers
Alanine Transaminase
Amylases
Glucose
Herbicides
Lactic Acid
Lipase
Potassium