Black Coloured Urine following Organophosphorus Poisoning: Report of Two Cases.

Aneesh Basheer,Kiran Kulirankal,Sudhagar Mookkappan,Nagarajan Natarajan,Vijay Shanmugham

doi:10.1155/2014/706021

Aneesh Basheer, Kiran Kulirankal + Show 3 more

Open Access

https://doi.org/10.1155/2014/706021

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Abstract

Organophosphorus poisoning is common in rural Asia. Clinical features result from overactivity of acetylcholine receptors. Blackish discoloration of urine is not a feature of organophosphorus poisoning. Only one case of black colored urine following quinalphos poisoning has been reported in literature. We report two cases of organophosphorus poisoning from two different compounds, following which patients passed black colored urine, in the absence of haemolysis or rhabdomyolysis. These cases indicate that blackish discoloration of urine in organophosphorus poisoning might not be as uncommon as it was believed to be. Besides, urinary excretion of metabolites might be an underlying mechanism, rather than hemolysis.

Highlights

The public health importance of organophosphorus poisoning is reflected in the huge number of deaths due to suicidal and accidental toxicity from these compounds [1]
Atypical complications like pancreatitis and haemolysis have been described [4, 5], only one case of blackish discoloration of urine has been reported in literature, following quinalphos poisoning [6]
In the case reported by Viswanathan [6], the proposed mechanism for blackish discoloration of urine was hemolysis caused by quinalphos

Summary

Introduction

The public health importance of organophosphorus poisoning is reflected in the huge number of deaths due to suicidal and accidental toxicity from these compounds [1]. Characteristic signs and symptoms of toxicity, and low serum cholinesterase levels make the diagnosis almost certain [2]. Intermediate syndrome causing respiratory failure is one of the most dreaded complications [3]. Atypical complications like pancreatitis and haemolysis have been described [4, 5], only one case of blackish discoloration of urine has been reported in literature, following quinalphos poisoning [6]. This report describes two cases sharing this atypical manifestation, but due to different compounds

Case Report

Findings

Discussion

Conclusion