ISSN: 2149-2247 | E-ISSN: 2149-2549

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Effects of Organophosphate Poisoning on Endocrine System in Long-Term: A Pilot Study [Erciyes Med J]
Erciyes Med J. Ahead of Print: EMJ-32041 | DOI: 10.14744/etd.2019.19122

Effects of Organophosphate Poisoning on Endocrine System in Long-Term: A Pilot Study

Zuhal Özer Şimşek1, Mustafa Sevim2, Yasin Şimşek3, Murat Sungur1, Kürşat Gündoğan1, Muhammet Güven1
1Division of Intensive Care, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey
2Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey
3Division of Endocrinology and Metabolism, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey

Introduction: Organophosphates (OPs) are widely used for pest control worldwide, leading to increased risk for human exposure. Acute hormonal effects of OP include deficiencies in thyroid-stimulating hormone (TSH), adrenocorticotrophic hormone (ACTH) and insulin-like growth factor (IGF-1) correlated with levels of cholinesterase. Most patients with OP related hormone deficiency recover at 3 months of follow up. However, chronic effects of these chemicals are not clear. The aim of this study was to determine the chronic influences of OP on pituitary functions in patients who had poising of OP.
Patients and methods: This prospective study was performed in Erciyes University Medical School. All of the patients had OP poisoning were followed up in Medical Intensive Care Unit (MICU). They evaluated after discharge from MICU at least after 6 months in terms of pituitary functions. In all patients, data were extracted from MICU records. Baseline hormone levels were assessed and dynamic tests (ITT= insulin tolerance test and GST= glucagon stress test) were performed.
Results: Twenty-nine adult patients (13 women, 16 men) with OP poisoning were included in the study. The mean age was 41.9±16.7 years. The mean time from hospitalization to assessment of pituitary functions was 43.9 ± 15.8 months in patients with OP poisoning. All patients had normal prolactin, TSH, follicle-stimulating hormone (FSH) and luteinising hormone (LH) levels. The women had normal estrogen levels and men had normal total testosterone levels. Cortisol deficiency was detected in only one patient (3.4%) and 3 patients had GH insufficiency (10.3%).
Conclusion: GH and cortisol axis may be affected by OP poisoning in long-term. Thus, pituitary hormone levels should be tested following acute period in patients with OP.

Keywords: Organophosphate poisoning, Endocrine effects, Pituitary functions



Corresponding Author: Zuhal Özer Şimşek, Türkiye
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