A Case of Acute Organotin Poisoning

Abstract ─ A Case of Acute Organotin Poisoning Yu Jung Kim, Yangho Kim, Kyoung Sook Jeong, Chang Sun Sim, Nari Choy, Jongchul Kim 1) ,Jun Bum Eum 2) , Yoshiaki Nakajima 3) , Yoko Endo 3) , Cheol-In Yoo Department of Occupational and Environmental Medicine, Department of Neurology 1) ,Department of Internal medicine 2) , Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, KoreaResearch Center for Occupational Poisoning, Tokyo Rosai Hospital, Japan 3) Background : Although organotin compounds are widely used as PVC stabilizers, catalysts and bio-cides, their effects on humans are not well known. However, their acute intoxication is known to causeneurotoxicity in the central nervous system, renal toxicity, and hepatotoxicity. As there has been no pre-viously published case of organotin intoxication in Korea, we report here the first Korean case of acuteexposure to organotin. Case report : A 43-year-old male with disorientation and behavioral change was admitted to a hospital.He had been working as a tank cleaner for several different companies in the previous 8 years and a weekbefore admission, he had cleaned a tank containing dimethyltin (DMT) for 4 days. A day after finishingthe job, he suffered decreased memory, behavioral change and progressive mental deterioration when hearrived at the emergency room. The result of spinal tapping was negative but on the 4th day of admissionhe deteriorated into a state of coma along with metabolic acidosis and severe hypokalemia.High levels of DMT and trimethyltin (TMT) were detected in a highly sensitive urine analysis. Afterconservative treatment and chelation therapy, the patient showed some clinical improvement but the neu-rological defects persisted.