Acute 2,4-dichlorophenoxyacetic acid (2,4-D) poisoning in a young adult: A case report of rhabdomyolysis, conservative management, and favorable outcome

Abstract

Dichlorophenoxyacetic acid (2,4-D) is one of the herbicides mainly used to control broadleaf weeds in many crops. This is a case report about 18-year-old young male who referred to the emergency department (ED) with chief complaints of nausea, vomiting, and gastroesophageal reflux According to the medical history, he had been exposed to the 2,4-D, by drinking of this toxic agent. In addition, his vital signs were as follows: Blood pressure=75/110, heart rate=97, respiratory rate=19, and SPO2=96%. The electrocardiogram and arterial blood gas analysis obtained (ABG), as well as total laboratory tests were normal. He had a normal state of consciousness and was hemodynamically stable. All clinical examinations were also normal. As a therapeutic measure, hydration was performed via infusion of normal saline (1 Liter), and the patient was admitted to the toxicology ward for further follow-up. Upon 12 hours of hospitalization, the patient’s serum creatine kinase (CK) began to rise and reached 1308 within two days. Finally, CK serum levels were reduced following treatment with normal saline. After 48 h, the patient was discharged with normal CK.

Keywords: Dichlorophenoxyacetic acid, Creatine kinase, Poisoning, Herbicides