Amitraz poisoning, an emerging problem: epidemiology, clinical features, management, and preventive strategies

• Published in: Archives of disease in childhood Vol. 88; no. 2; pp. 130 - 134
• Main Authors: Yilmaz, H L, Yildizdas, D R
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01-02-2003; BMJ; BMJ Publishing Group Ltd; BMJ Publishing Group LTD
• Subjects: Acaricides; Accidental poisoning; adrenergic agonist; alanine aminotransferase; ALT; amitraz; Anatomy; Animals; aspartate aminotransferase; AST; Biological and medical sciences; Biomarkers - blood; Blood Glucose - analysis; blood urea nitrogen; Body temperature; BUN; Care and treatment; Causes of; central nervous system; Charcoal - therapeutic use; Child; Child, Preschool; CNS; Coma; Coma - chemically induced; Drug dosages; ECG; electrocardiogram; Epidemiology; Female; Females; Gastric Lavage; GCS; Glasgow coma score; Health aspects; Humans; Hypothermia; Infant; Ingestion; Insecticides; Insecticides - poisoning; Laboratories; Length of Stay; lethal dose; Male; Males; MAO; Medical sciences; monoamine oxidase; Original; Patients; Pesticides, fertilizers and other agrochemicals toxicology; Poisoning; Poisoning, Accidental; Poisons; Poverty Areas; Rural areas; Side effects; Studies; Suicides & suicide attempts; Summer; Toluidines - poisoning; Toxicology; Transaminases - blood; Treatment Outcome; Visual Impairments; Turkey; Human; Prevention; Clinical management; Amitraz; Strategy; Poisoning; Child; Epidemiology
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/adc.88.2.130

Background: Amitraz is a pharmaceutical, veterinary, and agricultural product which is used worldwide under numerous generic names as an acaricide and insecticide. Because of its widespread use amitraz poisoning has come emerged as a cause of childhood poisoning during the past decade, particularly more in certain countries such as Turkey. Aims and Methods: To report the clinical features, the management, and the preventive strategies of amitraz poisoning in nine children, and review the previously reported 137 cases in humans. Results: Five male and four female children aged 10 months to 8 years were admitted to our department. The estimated ingested dose ranged between 89.2 and 163 mg/kg and estimated time from ingestion to presentation was 30–120 minutes. The initial signs and symptoms were impaired consciousness, drowsiness, vomiting, disorientation, miosis, mydriasis, hypotension, bradycardia, tachypnoea, hypothermia, and generalised seizures. Hyperglycaemia, glycosuria, and minimal increase in transaminase levels were observed. None required mechanical ventilation. CNS depression resolved spontaneously within 4–28 hours in all. The length of hospital stay was two to three days; all had a good outcome. Conclusion: This review details preventive measures and management strategies of amitraz poisoning, including the importance of following patients closely in the intensive care unit, monitoring their respiratory, cardiovascular, and central nervous systems since they may occasionally experience serious cardiopulmonary side effects.