Leucocytoclastic vasculitis after citric acid intoxication
AuthorTerekeci, Murat Hakan
Yücetürk, Tolga Enver
MetadataShow full item record
CitationTerekeci, M. H., Şahan, B., Nalbant, S., Yücetürk, T. E., Haholu, A., Çelik, S., Tangi, F. ve Öktenli, Ç. (2008). Leucocytoclastic vasculitis after citric acid intoxication. The Internet Journal Of Toxicology, Internet Scientific Publications. 6(1), s. 1-4.
Background: Citric acid is widely used in detergent industry. Information about citric acid intoxication is limited. Its ingestion is a life-threatening condition that requires a multidisciplinary approach.Case report: A 44 year-old male patient arrived to the hospital after a suicide attempt by taking 150 ml of dishwasher polisher. Vomiting was induced by his relatives before coming to hospital 4 hours after. Arterial blood-gas and electrolytes evaluation revealed blood-pH and potassium to be 7.15 and 6.13 mg/dL, respectively, and an increased plasma anion gap. Two weeks later, bilateral vocal cord paralysis was diagnosed and tracheostomy was performed. Internal Medicine consultation revealed a initial diagnosis of vasculitis and he was admitted to Internal Medicine Department. There was a diffuse cutaneous petechial rash which was nonpalpable and the largest one was about 2 cm diameter. The pathological punch biopsy sample taken from the lower part of the left leg, where there was diffuse rash, revealed leucocytoclastic vasculitis. One mg/kg prednizolone was started after vasculitis was confirmed pathologically. Cutaneous lesions recovered dramatically. Discussion: Many drugs are indicated to cause leucocytoclastic vasculitis. Antibiotic, especially those of penicilin group and clarithromycin are reported to cause leucocytoclastic vasculitis and henoch-schönlein purpura. Other agents that may cause leucocytoclastic vasculitis development are non-steroid anti-inflammatory drugs, proplytiouracil, paracetamol, simetidin, streptokinase, metformin and acenocumaral. There’s no other case in literature as ours who took foreign substances such as citric acid for suicidal purposes rather than treatment purposes. The only case found in literature about citric acid had metabolic acidosis with high level of anion gap, which recovered after ionized calcium infusion; however, its follow up do not report a leucocytoclastic vasculitis similar to our case.
SourceThe Internet Journal Of Toxicology
- Makale Koleksiyonu 
The following license files are associated with this item: