Toxic Encephalopathy and Methemoglobinemia after 5-Amino-2-(trifluoromethyl)pyridine Poisoning

Yiming Tao; Longke Shi; Jie Han; Xiangdong Jian; Yongsheng Li

doi:10.3390/ijerph192114031

Toxic Encephalopathy and Methemoglobinemia after 5-Amino-2-(trifluoromethyl)pyridine Poisoning

Int J Environ Res Public Health. 2022 Oct 28;19(21):14031. doi: 10.3390/ijerph192114031.

Authors

Yiming Tao^{1

2}, Longke Shi³, Jie Han⁴, Xiangdong Jian⁵, Yongsheng Li^{1

2}

Affiliations

¹ Department of Intensive Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hankou, Wuhan 430030, China.
² Department of Emergency, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hankou, Wuhan 430030, China.
³ School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
⁴ Department of Emergency, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao 266071, China.
⁵ Department of Poisoning and Occupational Diseases, Qilu Hospital of Shandong University, No. 107, Road Wenhuaxi, Jinan 250012, China.

Abstract

The aromatic amino compound 5-amino-2-(trifluoromethyl)pyridine acts as an intermediate in the synthesis of pharmaceutical products. However, the toxicity profile of this compound is sparse and no related poisoning events have been reported. Here, we report the case of a 35-year-old man who inhaled 5-amino-2-(trifluoromethyl)pyridine at work. After inhalation, the patient rapidly developed symptoms such as dizziness, fatigue, nausea, vomiting, chest tightness, and loss of consciousness. After admission, methemoglobinemia, hemolytic anemia, acute renal failure, and toxic encephalopathy occurred. Symptoms improved significantly after intravenous treatment with a low dose of methylene blue. This revealed that 5-amino-2-(trifluoromethyl)pyridine is toxic to the human body and can be absorbed through the respiratory tract, resulting in methemoglobinemia and toxic encephalopathy; thus, caution should be taken in industrial production.

Keywords: 5-amino-2-(trifluoromethyl)pyridine; acute renal failure; magnetic resonance imaging; methemoglobinemia; toxic encephalopathy.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Anemia, Hemolytic* / drug therapy
Humans
Male
Methemoglobinemia* / chemically induced
Methemoglobinemia* / drug therapy
Methylene Blue
Neurotoxicity Syndromes*
Poisoning*
Pyridines / therapeutic use
Pyridines / toxicity

Substances

Methylene Blue
Pyridines

Grants and funding

This study was supported by the Beijing medical and health foundation (Grant no. YWJKJJHKYJJ-BXS5-22001) and the Chen Xiao-ping Foundation for the Development of Science and Technology of Hubei Province (Grant no. CXPJJH12000005-07-40).