Journal article
Toxicology laboratory analysis and human exposure to p-chloroaniline
Clinical toxicology (Philadelphia, Pa.), Vol.47(2), pp.132-136
02/2009
DOI: 10.1080/15563650801971390
PMCID: PMC2656391
PMID: 18608262
Abstract
Introduction. p-Chloroaniline is more potent at producing methemoglobin than aniline in animal models. This case highlights the clinical presentation of an inhalation exposure to p-chloroaniline and associated laboratory analysis. An in-vitro study evaluating the metabolism of p-chloroaniline in human hepatocytes was undertaken to evaluate the metabolic fate more closely. Case presentation. A 20 year-old man was working at a chemical waste plant when he developed dizziness, abdominal pain, and nausea. The exam was remarkable for coma, tachycardia, cyanosis, and pulse oximetry of 75%. Arterial blood gases showed a pH 7.38, pCO2 41 mmHg, pO2 497 mmHg, bicarbonate 24 mEq L and methemoglobin 69%. Methylene blue administration led to complete recovery without sequelae. p-Chloroaniline was later identified as the chemical involved. He denied direct contact with the chemical, but was not wearing a dust mask or respirator. GC MS confirmed p-chloroaniline and metabolites in the patient's urine. Methods. Human hepatocytes were incubated with 100 μM p-chloroaniline for 24 hours, in both rifampicin- and vehicle only-treated cells. The cell culture medium was collected for GC MS analysis for p-chloroaniline metabolites. Results. Similar to the patient sample, both p-chloroaniline and p-chloroacetanilide were identified by GC MS in hepatocytes incubated with p-chloroaniline. Neither p-chloroaniline incubated in empty cell culture nor direct GC MS injection of p-chloroaniline generated any p-chloroacetanilide via non-enzymatic degradation. Discussion Conclusion. The seemingly innocuous dermal and inhalation exposure to p-chloroaniline dust can lead to life-threatening methemoglobinemia. The diagnosis can be confirmed with GC MS analysis of the patient's urine, searching for p-chloroaniline and its primary metabolite p-chloroacetanilide.
Details
- Title: Subtitle
- Toxicology laboratory analysis and human exposure to p-chloroaniline
- Creators
- Anthony F Pizon - 1University of Pittsburgh Medical Center, Department of Emergency Medicine, Division of Medical Toxicology, Pittsburgh, Pennsylvania, USAAnna R Schwartz - 2University of Pittsburgh Medical Center, Department of Emergency Medicine, Pittsburgh, Pennsylvania, USALeo M Shum - 2University of Pittsburgh Medical Center, Department of Emergency Medicine, Pittsburgh, Pennsylvania, USAJon C Rittenberger - 2University of Pittsburgh Medical Center, Department of Emergency Medicine, Pittsburgh, Pennsylvania, USADarla R Lower - 2University of Pittsburgh Medical Center, Department of Emergency Medicine, Pittsburgh, Pennsylvania, USASpiros Giannoutsos - 3University of Pittsburgh Medical Center, Department of Pathology, Division of Clinical Chemistry, Pittsburgh, Pennsylvania, USAMohamed A Virji - 3University of Pittsburgh Medical Center, Department of Pathology, Division of Clinical Chemistry, Pittsburgh, Pennsylvania, USAMatthew D Krasowski - 3University of Pittsburgh Medical Center, Department of Pathology, Division of Clinical Chemistry, Pittsburgh, Pennsylvania, USA
- Resource Type
- Journal article
- Publication Details
- Clinical toxicology (Philadelphia, Pa.), Vol.47(2), pp.132-136
- DOI
- 10.1080/15563650801971390
- PMID
- 18608262
- PMCID
- PMC2656391
- NLM abbreviation
- Clin Toxicol (Phila)
- ISSN
- 1556-3650
- eISSN
- 1556-9519
- Publisher
- Informa UK Ltd
- Language
- English
- Date published
- 02/2009
- Academic Unit
- Pathology
- Record Identifier
- 9984046833702771
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