Dimethylacetamide, ethylenediamine, and diphenylmethane diisocyanate poisoning manifest as acute psychosis and pulmonary edema: treatment with hemoperfusion

J Toxicol Clin Toxicol. 2000;38(4):429-33. doi: 10.1081/clt-100100953.

Abstract

A 27-year-old man, employed by a synthetic fiber company, had been exposed to dimethylacetamide, ethylenediamine, and diphenylmethane diisocyanate in a confined space continuously for 4-6 hours per day for 3 days before admission. Hallucinations and delusions were noted at admission; pulmonary edema developed subsequently. The electroencephalogram showed diffuse moderate cortical dysfunction and slow waves at 4-7 Hz, 20-80 microV. Seizures, liver injury, and rhabdomyolysis were noted on the 4th hospital day. The patient was treated by hemoperfusion with a decrease in urine dimethylacetamide from 3,265 mg/g to 4 mg/g creatinine over 4 days. Serial urinary dimethylacetamide and electroencephalogram correlated with the clinical condition.

Publication types

  • Case Reports

MeSH terms

  • Acetamides / poisoning*
  • Acetamides / urine
  • Adult
  • Charcoal / therapeutic use
  • Delusions / chemically induced
  • Electroencephalography / drug effects
  • Ethylenediamines / poisoning*
  • Hallucinations / chemically induced
  • Hemoperfusion
  • Humans
  • Inhalation Exposure / adverse effects
  • Isocyanates / poisoning*
  • Male
  • Occupational Exposure / adverse effects
  • Psychotic Disorders / etiology*
  • Psychotic Disorders / therapy
  • Pulmonary Edema / chemically induced*
  • Pulmonary Edema / therapy
  • Seizures / chemically induced
  • Skin Absorption
  • Skin Ulcer / chemically induced
  • Treatment Outcome

Substances

  • Acetamides
  • Ethylenediamines
  • Isocyanates
  • Charcoal
  • ethylenediamine
  • 4,4'-diphenylmethane diisocyanate
  • dimethylacetamide
  • N-methylacetamide