Organophosphate Poisoning and Intermediate Syndrome

Abstract

Toxic effects that occur after acute organophosphate poisoning (OP) can manifest three phases, namely, acute cholinergic crisis, intermediate syndrome and delayed-type polyneuropathy. Clinical signs and symptoms of organophosphate poisoning depend on the accumulation of acetylcholine at the nerve junction.  Organophosphate poisoning causes three main clinical findings; acute cholinergic crisis consisting of muscarinic, nicotinic and central nervous system symptoms, intermediate syndrome with recurrence of cholinergic symptoms or muscle weakness without fasciculation 24-96 hours after poisoning and delayed-type polyneuropathy that can usually occur several days or weeks after acute exposure to organic phosphorus compounds. In this article, intermediate syndrome, which is a late complication, has been reviewed.

Keywords

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Organofosfat Zehirlenmesi ve İntermediate Sendromu

Öz

Akut organofosfat zehirlenmesinden sonra oluşan toksik etki; akut kolinerjik kriz, intermediate sendrom ve gecikmiş polinöropati olarak üç fazda oluşmaktadır. Organofosfat zehirlenmesinde  klinik belirti ve bulgular asetilkolinin sinir kavşaklarında birikiminine bağlıdır. Muskarinik bulgular, Nikotinik bulgular ve Santral sinir sistemi bulgularından oluşan akut kolinerjik kriz, organofosfat zehirlenmesinde zehirlenmeden 24-96 saat sonra kolinerjik bulguların tekrarlaması ya da fasikülasyon olmadan kas zayıflığının meydana geldiği intermediate sendrom ve genellikle organik fosfor bileşiğine akut maruz kalınmasından sonraki birkaç gün veya hafta sonrasında meydana gelebilen gecikmiş tip polinöropati olarak üç temel klinik bulguya neden olmaktadır. Bu derleme yazımızda geç komplikasyonlardan olan intermediate sendromu gözden geçirilmiştir.

Anahtar Kelimeler

• Acil Servis, intermediate sendrom, organofosfat zehirlenmesi

Kaynakça

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68. Correspondence Address / Yazışma Adresi Mustafa Yılmaz
69. Fırat Üniversitesi. Tıp Fakültesi
70. Acil Tıp Anabilim Dalı. Elazığ, Turkey
71. e-mail: [e-mail]
72. Geliş tarihi/ Received: 12.04.2015
73. Kabul tarihi/Accepted: 03.06.2015