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Toxicological information

Direct observations: clinical cases, poisoning incidents and other

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Administrative data

Endpoint:
direct observations: clinical cases, poisoning incidents and other
Type of information:
migrated information: read-across based on grouping of substances (category approach)
Adequacy of study:
key study
Study period:
Not reported
Reliability:
2 (reliable with restrictions)
Rationale for reliability incl. deficiencies:
other: Study well documented, meets generally accepted scientific principles, acceptable for assessment
Cross-referenceopen allclose all
Reason / purpose:
reference to same study
Reason / purpose:
reference to other study

Data source

Reference
Reference Type:
publication
Title:
Unnamed
Year:
1981

Materials and methods

Study type:
poisoning incident
Endpoint addressed:
acute toxicity: oral
Test guideline
Qualifier:
no guideline required
Principles of method if other than guideline:
A case report of accidental ingestion of liquid zinc chloride in a 24 yr old man has been presented.
GLP compliance:
no

Test material

Reference
Name:
Unnamed
Type:
Constituent
Details on test material:
- Name of test material (as cited in study report): "Ruby Red" solder flux (zinc chloride solution)

Method

Type of population:
general
Subjects:
- Number of subjects exposed: One (Healthy Navy seaman)
- Sex: Man
- Age: 24 yr
- Demographic information: United States
Ethical approval:
not applicable
Route of exposure:
oral
Reason of exposure:
accidental
Exposure assessment:
estimated
Details on exposure:
Ingestion of around three ounces of solution that had been stored in a soft drink container.
Examinations:
- Vital signs, chest radiograph and electrocardiogram; urine analysis; hematology; clinical biochemistry; serum zinc level; fiberoptic esophagogastroduodenoscopy; endoscopy

All these examinations were performed after admission into National Naval Medical Center around 4 h after ingestion
Medical treatment:
Treatment 1 (when aboard): Gastric lavage and activated charcoal administration
Treatment 2 (at nearby shore facility): Administration of liquid antacids and calcium edetate through the nasogastric tube
Treatment 3 (at National Naval Medical Centre): Rapid intravenous hydration with normal saline and chelation therapy with calcium disodium edetate at 15 mg/kg (intravenous) every 12 h. A total of three dosages of calcium were administered.

Results and discussion

Clinical signs:
Burning pain in the mouth and throat and vomiting immediately after ingestion. Abdominal pain, nausea, projectile vomiting, lethargy and confusion developed afterwards. Theoropharynx was erythematous with superficial erosions and patch desquamation of the tongue, palate, and pharynx. Palpation of the abdomen revealed direct tenderness in the midepigastrium. There were no focal neurologic deficits.
Results of examinations:
- Vital signs: Temperature - 37.22 °C; Pulse - 96 beats/min.; Respirations - 16/min.; Blood pressure - 110/70 mm Hg
-Chest radiograph and electrocardiogram: Normal
- Urine analysis: Numerous red blood cells without casts or other cellular elements in urine
- Hamatology: Normal hemogram; white blood cell count - 13,800/mm3 with left shift; PT, PTT, and platelets were normal; the peripheral smear was unremarkable
-Clinical biochemistry: Electrolytes were normal except for potassium (3.3 mEq/L); Blood sugar - 221 mg/dL (elevated; the patient had not eaten for 14 h); Calcium - 9.4 mg/dL (decreased); Phosphorus - 3.5 mg/dL; Magnesium - 0.6 mg/dL; Amylase - 183 mg/dL (elevated); SGOT, SGPT, APH, and total bilirubin were normal; Creatine - 1.0 mg/dL
-Initial serum zinc level: 146 µg/dL (normal 50 to 90)
-Fiberoptic esophagogastroduodenoscopy: Erythema, edema, and erosion of the pharynx and esophagus without frank ulceration
-Endoscopy: Mild diffuse erythema of the stomach
Effectivity of medical treatment:
Treatment 1: Severe abdominal pain, nausea, and projectile vomiting were noted after treatment
Treatment 2: Projectile vomiting persisted and lethargy developed
Treatment 3: Blood glucose and amylase remained elevated, and mild hypocalcemia persisted. Within 24 h of chelation therapy, serum zinc levels werenormal at 48 µg/dL. The patient continued to have microhematuria over the next 72 h without deterioration of renal function. Abdominal pain, hyperglycemia, and hyperamylasemia resolved within 72 h.
Outcome of incidence:
The patient was recovered within 5 d

Any other information on results incl. tables

None

Applicant's summary and conclusion

Conclusions:
Not applicable
Executive summary:

The case of a 24-year-old man who accidentally ingested liquid zinc chloride was presented.

Accidental ingestion of around three ounce zinc chloride solution caused local caustic effects including erosive pharyngitis and esophagitis with sever pain. Lethargy and confusion were present as seen in other cases of hyperzincemia. Nausea, vomiting and abdominal pain, as well as hypocalcemia and hyperamylasemia, were observed indicating acute pancreatitis. There were no focal neurologic deficits. Chest radiograph, electrocardiogram and hemogram were normal. Microhematuria occurred, but renal function did not deteriorate.

Chelation therapy was instituted, with reversal of the clinical and biochemical effects of zinc poisoning. The patient was recovered in 5 d.