A five-day-old victim of chemical terrorism was exposed to sulfur mustard

Year 2024, Volume: 52 Issue: 5, 293 - 297, 12.12.2024

Sermet Sezigen , Sadık Topuzoğlu

https://doi.org/10.15671/hjbc.1592611

Abstract

Sulfur mustard (SM) is a blistering chemical warfare agent and it has cytotoxic effects on ocular, respiratory, cutaneous, and hematological systems. We presented acute hematological effects of high-dose SM exposure on a five-day-old victim who was exposed to SM in Syria in 2015, during a chemical attack. Following onset of typical ocular, respiratory, and cutaneous symptoms of SM, the patient was evacuated to Türkiye on 18th hour after the exposure with an initial diagnosis of second-degree chemical burn. The patient died on 14th day after the exposure. Severe thrombocytopenia, reactive leucocytosis followed by mild leukopenia, isolated lymphopenia, and anaemia were observed after SM exposure. Besides symptomatic treatment, granulocyte-colony stimulating factor (G-CSF), packed red blood cells transfusions, and platelet transfusions were administered for the treatment of hematological complications. Monitoring hematological indices daily, advanced medical interventions including G-GSF treatment for SM-induced neutropenia, and aggressive resuscitation with multiple blood transfusions could reduce the impact of myelosuppression in victims of SM.

Keywords

Sulfur mustard, Myelosuppression, Chemical terrorism

References

• M Tabarestani, M Balau-Mood, M Farhoodi, Hematological findings of sulphur mustard poisoning in Iranian combatants, Med J Islam Repub Iran, 4 (1990) 185-190.
• S Sezigen, K Ivelik, M Ortatatli, M Alamacıoglu, M Demirkasimoglu, RK Eyison, ZI Kunak, L. Kenar, Victims of chemical terrorism, a family of four who were exposed to sulfur mustard, Toxicol Lett., 303 (2019) 9-15.
• E Kilic, M Ortatatli, S Sezigen R.K, Eyison, L. Kenar, Acute intensive care unit management of mustard gas victims: the Turkish experience, Cutan Ocul Toxicol., 37 (2018) 332-337.
• M. Balali-Mood, M. Abdollahi, Basic and clinical toxicology of mustard compounds, Springer, New York, USA, 2015.
• I. Roberts, NA. Murray, Neonatal thrombocytopenia: causes and management, Arch Dis Child Fetal Neonatal Ed., (88) 2003 F359-64.
• S. Sezigen, R.K. Eyison, M. Ortatatli, E. Kilic, L. Kenar, Myelosuppression and acute hematological complications of sulfur mustard exposure in victims of chemical terrorism, Toxicol Lett., (318) 2020 92-98.
• J. Goverman, R. Montecino, A. Ibrahim, K. Sarhane, RP. Tompkins, SP Fagan, Sulfur mustard gas exposure: case report and review of the literature, Ann Burns Fire Disasters, 27 (2014) 146-150.
• S. Sezigen, L. Kenar, Recent sulfur mustard attacks in Middle East and experience of health professionals, Toxicol Lett., 320 (2019) 52-57.
• D.R. Anderson, W.W. Holmes, R.B. Lee, S.J. Dalal, C.G. Hurst, B.I. Maliner, J. Newmark, W.J. Smith, Sulfur mustard-induced neutropenia: treatment with granulocyte colony-stimulating factor, Mil Med., 171 (2006) 448-453.