Tetramine poisoning: A case report and review of the literature

Abstract

Background: Tetramethylene disulfotetramine (TETS), a banned neurotoxic rodenticide, has accounted for numerous intentional and unintentional poisonings in mainland China. Since the first known case of human illness caused by tetramine occurred in NewYork, in May 2002, TETS has caused more than 50 human poisonings in Western countries.

Aim: To analyze pathological changes of TETS poisoning and to provide evidence for forensic identification.

Methods: We report the case of a 28-year-old female who suffered from tetramine poisoning and died of multi-organ failure. We also performed a retrospective study of 40 cases of poisoning, from pathological autopsy reports, by analyzing and summarizing the related the literature from 1996 to 2010. Based on pathologic autopsies and the literature, we summarize the pathological changes related to tetramine poisoning.

Results: Signs of asphyxia were obvious upon pathological examination. Edema and congestion of organs, particularly in the brain, were seen in all cases. Subarachnoid and cerebral hemorrhaging were also common signs of tetramine poisoning.

Conclusion: In forensic practice, tetramine poisoning should be considered when the patient has signs of abnormal excitation of the central nervous system, convulsions, hyperspasmia, and cerebral hemorrhage.