Registration Dossier

Toxicological information

Direct observations: clinical cases, poisoning incidents and other

Administrative data

Endpoint:
direct observations: clinical cases, poisoning incidents and other
Type of information:
migrated information: read-across from supporting substance (structural analogue or surrogate)
Adequacy of study:
key study
Study period:
1981
Reliability:
2 (reliable with restrictions)
Rationale for reliability incl. deficiencies:
other: Results from publication with well described details
Cross-referenceopen allclose all
Reason / purpose:
reference to same study
Reason / purpose:
reference to other study

Data source

Reference
Reference Type:
publication
Title:
Acute poisoning with pine oil - metabolism of monoterpenes
Author:
Köppel C, Tenczer J, Tönnesmann U, Schirop T and Ibe K
Year:
1981
Bibliographic source:
Archives of Toxicology 49(1):73-8

Materials and methods

Study type:
poisoning incident
Endpoint addressed:
basic toxicokinetics
Principles of method if other than guideline:
The blood and urine monoterpene concentrations were continuously monitored from a patient attempting suicide by ingestion of 400-500 mL pine oil.
GLP compliance:
no

Test material

Reference
Name:
Unnamed
Type:
Constituent
Type:
Constituent
Test material form:
other: liquid
Details on test material:
Name of test material (as cited in study report): pine oil
Composition of test material, percentage of components: 57% alpha-pinene, 8% beta-pinene, 26% carene, 6% limonene and 3% other hydrocarbons

Method

Type of population:
general
Subjects:
A 49 year old male (height 185 cm, body weight 85 kg)
Ethical approval:
not specified
Route of exposure:
oral
Reason of exposure:
intentional
Exposure assessment:
estimated
Details on exposure:
400-500 mL of pine oil
Examinations:
- blood and urine analyses for α-pinene concentration
- detection of metabolites in urine
- circulatory functions, temperature, pulse
- electro encephalogram (EEG)
Medical treatment:
After continuous stomach lavage 250 mL paraffine oil and saline laxatives were given. Hemoperfusions with activated charcoal and amberlite and a hemodialysis were performed.

Results and discussion

Clinical signs:
Psychomotric excitation, headache, erythem of mouth and larynx, a flush of the face, ataxia, and a spontaneous hyperventilation. With a latence of 10 h after ingestion the consciousness of the patient was impaired and the circulatory parameters became instable although a hypovolemy could be excluded.
Results of examinations:
The circulatory parameters and the laboratory data were in the normal range. The EEG recorded the second day revealed a decelerated activity. No epileptogenic activities could be detected. The patient had a retrograde amnesia for the period of somnolence and sopor. At this time a leukocytosis (21000/mm3), a slight raise of the transaminases, and a reduction of the pseudocholinesterase (1446 U/L) were observed. The renal functions were not affected except a transient oliguria which was due to the drop of the blood pressure.
Effectivity of medical treatment:
After infusion of dopamine and dobutamine, the circulatory functions stabilized. Hemoperfusion eliminates monoterpenes quite effectively from the blood compartment thereby protecting the renal functions.
Outcome of incidence:
Three weeks later the patient left the clinic without any bodily complaints.

Applicant's summary and conclusion

Conclusions:
Psychomotric excitation, headache, erythem of mouth and larynx, a flush of the face, ataxia, and a spontaneous hyperventilation can be observed after ingestion of a letal dose of pine oil (400-500 mL). Impaired conciousness and instable circulatory parameters can happen several hours after ingestion. After infusion of dopamine and dobutamine, the circulatory functions stabilized. Hemoperfusion eliminated monoterpenes thereby protecting the renal functions.
Executive summary:

A patient attempting suicide ingested 400-500 mL pine oil and was admitted to the clinic. Since more than the potentially lethal dose had been ingested hemoperfusions with activated charcoal and amberlite and a hemodialysis were performed. Clinical signs observed were: psychomotric excitation, head ache, erythem of mouth and larynx, a flush of the face, ataxia, and a spontaneous hyperventilation. With a latence of 10 h after ingestion the consciousness of the patient was impaired and the circulatory parameters became instable although a hypovolemy could be excluded. Three weeks later the patient left the clinic without any bodily complaints.