Chronic carbon monoxide poisoning. A report of two cases
https://doi.org/10.4081/ecj.2021.9677
Accepted: 20 April 2021
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
If acute carbon monoxide poisoning is a well-known emergency situation, this is not the case for chronic poisoning. The missed diagnosis of acute CO poisoning is a well-known problem but the identification of a chronic poisoning is very challenging. Knowledge and awareness of chronic poisoning is less defined and probably there is a great number of patients with undiagnosed chronic CO poisoning. It is possible that in case of missed diagnosis because of non-specific symptoms, chronic CO poisoning could be responsible for significant morbidity. We describe the case of a married couple who were rescued almost simultaneously, to show this clinical condition.
Locatelli C. Intossicazione acuta da monossido di carbonio: il punto di vista del tossicologo. Medicina Subacquea e Iperbarica 2009;2:19-23.
Kao LW, Nañagas KA. Carbon monoxide poisoning. Med Clin North Am 2005;89:1161-94. DOI: https://doi.org/10.1016/j.mcna.2005.06.007
Wright J. Chronic and occult carbon monoxide poisoning: we don't know what we're missing. Emerg Med J 2002;19:386-90. DOI: https://doi.org/10.1136/emj.19.5.386
Heckerling PS. Occult carbon monoxide poisoning: a cause of winter headache. Am J Emerg Med 1987;5:201–4. DOI: https://doi.org/10.1016/0735-6757(87)90320-2
Dolan MC, Haltom TL, Barrows GH, Short CS, Ferriell KM. Carboxyhemoglobin levels in patients with flu-like symptoms. Ann Emerg Med 1987;16:782-6. DOI: https://doi.org/10.1016/S0196-0644(87)80575-9
Hardy KR, Thom SR. Pathophysiology and treatment of carbon monoxide poisoning. J Toxicol Clin Toxicol 1994;32:613-29. DOI: https://doi.org/10.3109/15563659409017973
Zhang J, Piantadosi CA. Mitochondrial oxidative stress after carbon monoxide hypoxia in the rat brain. J Clin Invest 1992;90:1193-9. DOI: https://doi.org/10.1172/JCI115980
Wittenberg BA, Wittenberg JB. Effects of carbon monoxide on isolated heart muscle cells. Res Rep Health Eff Inst 1993;(62):1-12; discussion 13-21.
Radi R, Rodriguez M, Castro L, Telleri R. Inhibition of mitochondrial electron transport by peroxynitrite. Arch Biochem Biophys 1994;308:89-95. DOI: https://doi.org/10.1006/abbi.1994.1013
Rastelli G, Callegari S, Locatelli C, Vezzani G. Il danno miocardico indotto dall'intossicazione acuta da monossido di carbonio [Myocardial injury in carbon monoxide poisoning]. G Ital Cardiol 2009;10:227-33.
Balzan MV, Cacciottolo JM, Mifsud S. Unstable angina and exposure to carbon monoxide. Postgrad Med J 1994;70:699–702. DOI: https://doi.org/10.1136/pgmj.70.828.699
Ischiropoulos H, Beers MF, Ohnishi ST, et al. Nitric oxide production and perivascular nitration in brain after carbon monoxide poisoning in the rat. J Clin Invest 1996;97:2260-7. DOI: https://doi.org/10.1172/JCI118667
Thom SR, Fisher D, Manevich Y. Roles for platelet-activating factor and *NO-derived oxidants causing neutrophil adherence after CO poisoning. Am J Physiol Heart Circ Physiol 2001;281:H923-30. DOI: https://doi.org/10.1152/ajpheart.2001.281.2.H923
Hartsfield CL. Cross talk between carbon monoxide and nitric oxide. Antioxid Redox Signal 2002;4:301-7. DOI: https://doi.org/10.1089/152308602753666352
Heckerling PS, Leikin JB, Maturen A. Occult carbon monoxide poisoning: validation of a prediction model. Am J Med 1988;84:251-6. DOI: https://doi.org/10.1016/0002-9343(88)90421-4
Heckerling PS, Leikin JB, Terzian CG, et al. Occult carbon monoxide poisoning in patients with acute neurological illness. Clin Toxicol 1990;28:29–44. DOI: https://doi.org/10.3109/15563659008993474
Sadovnikoff N, Varon J, Sternbach GL. Carbon monoxide poisoning. An occult epidemic. Postgrad Med. 1992;92:86-8, 92-6. DOI: https://doi.org/10.1080/00325481.1992.11701467
Zorbalar N, Yesilaras M, Aksay E. Carbon monoxide poisoning in patients presenting to the emergency department with a headache in winter months. Emerg Med J 2014;31:e66-70. DOI: https://doi.org/10.1136/emermed-2012-201712
Rose JJ, Wang L, Xu Q, et al. Carbon monoxide poisoning: pathogenesis, management, and future directions of therapy. Am J Respir Crit Care Med 2017;195:596-606. Erratum in: Am J Respir Crit Care Med 2017;196:398-399. DOI: https://doi.org/10.1164/rccm.201606-1275CI
Koyuncu S, Bol O, Ertan T, et al. The detection of occult CO poisoning through noninvasive measurement of carboxyhemoglobin: A cross-sectional study. Am J Emerg Med 2020;38:1110-4. DOI: https://doi.org/10.1016/j.ajem.2019.158383
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Downloads
Citations
