A 21-year-old male patient was admitted with acute renal failure and intravascular hemolysis following suicidal parenteral copper sulfate poisoning. He developed metabolic acidosis and septicemia; and was treated with intensive hemodialysis, blood transfusions and antibiotics. After remaining anuric for 4 weeks, his urine output gradually increased. However his renal functions improved only partially. Renal biopsy done 8 weeks after the episode showed chronic tubulo-interstitial nephritis (CIN). This is the first reported case showing CIN following acute copper sulfate intoxication.

Chronic interstitial nephritis following parenteral copper sulfate poisoning

In dieser Zeitschrift haben in groseren Ubersichtsarbeiten 1919 Grafin Von Linden uber „Die bisherigen Tatsachen und die therapeutischen Aussichten der Kupfertherapie“ berichtet und 1935 A. H. Muller uber „Die Rolle des Kupfers im Organismus mit besonderer Berucksichtigung seiner Beziehungen zum Blute“. Die Bedeutung des Kupfers (Cu) in Physiologie und Pathologie geht aus diesen Ausfuhrungen schon eindrucksvoll hervor. 1941 haben dann Heilmeyer, Keiderling und Stuwe in einer Monographie „Kupfer und Eisen als korpereigene Wirkstoffe und ihre Bedeutung beim Krankheitsgeschehen“ mit einer den klinischen Verhaltnissen angepasten, verbesserten Cu-Bestimmungsmethode im Blute umfangreiche, wertvolle, eigene Ergebnisse aus der Beobachtung am Krankenbett zusammengestellt. Es besteht kein Zweifel, das die letzteren Autoren vor allem im deutschsprachigen Gebiet — im angelsachsischen Schrifttum wurde dem Cu schon etwas fruher grosere Beachtung geschenkt [s. Elvehjem (1935)] — wesentlich dazu beigetragen haben, die Aufmerksamkeit in wachsendem Mase auf die Wichtigkeit dieses Elementes im Lebensprozes zu lenken. Untersuchungen beim Kinde sind bis heute verhaltnismasig wenig durchgefuhrt worden und eine zusammenhangende Darstellung fehlt noch. Wenn diese Lucke ausgefullt werden soll, ist ein ausgiebiges Zuruckgreifen auf die wesentlichsten Ergebnisse, die beim erwachsenen Menschen, bei Tier und Pflanze erhalten wurden, eine notwendige Voraussetzung.

Die Bedeutung des Kupfers in Biologie und Pathologie unter besonderer Berücksichtigung des wachsenden Organismus

Copper is an essential trace element that is extremely toxic to organisms and organs at high doses. We have investigated the histological and biochemical effects of a toxic dose of copper sulfate on the liver of term Ross broiler chicks. Fertilized eggs were divided into three groups: experimental, injected with 50 mcg/0.1 ml copper sulfate in the air chambers on day 1; sham, injected with 0.1 ml saline; and control, no injection. Term chicks were killed and their livers investigated histologically, with hematoxylin-eosin-stained sections examined under light microscopy, and biochemically, for malondialdehyde and glutathione levels. Histological examinations showed copper-treated samples with granular degeneration and necrosis of hepatocytes and impairment to the cell lining of the remark cords. The samples had a congestive appearance, with blood in the vena centralis and sinusoids, slight connective tissue increase, and lymphocyte infiltration. Control and sham group sections had normal appearances. As oxidative damage parameters, in the copper-treated group, malondialdehyde levels were increased and glutathione levels decreased. In the sham and control groups, there were no significant differences. At this toxic dose, copper sulfate shows oxidative damage according to the histology of term chick liver that are confirmed biochemically by the changes in malondialdehyde and glutathione levels.

The Effects of Copper Sulfate on Liver Histology and Biochemical Parameters of Term Ross Broiler Chicks

The aim of this study was to explore the effects of selenium addition on hepatic tissue ultrastructure and mitochondrial antioxidant capacity in copper-overloaded rats. Eighteen adult male Sprague-Dawley (SD) rats were randomly divided into three groups (n = 6 per group). Each group received 1 mL (intragastrically) of water (control, group I) or water containing copper chloride (CuCl2, 1 mol/L) (group II) or a mixture of CuCl2 (1 mol/L) with sodium selenite (Na2SeO3, 0.05 mol/L) (group III) once daily for 30 days. Histological examination revealed normal hepatocyte structure and no ultrastructural changes in mitochondria in controls. In contrast, group II exhibited severe ultrastructural alterations, fuzzy mitochondrial membranes, irregularly shaped and fragmented rough endoplasmic reticulum (RER), and the high melanin content; group III also exhibited larger amounts of engulfing vesicles (EV) in the cytoplasm. Compared to controls, the CuCl2 treatment lowered (P < 0.05) hepatocyte enzymatic activities and increased lipid peroxidation as indicated by an increase in malondialdehyde (MDA) levels. The effects of CuCl2 were attenuated by simultaneous administration with Na2SeO3. These results indicated that the adverse effects of copper toxicity can be partially attenuated by providing a source of selenium.

The Protective Roles of Selenium on Hepatic Tissue Ultrastructure and Mitochondrial Antioxidant Capacity in Copper-Overloaded Rats.

Partindo do fato de que o metabolismo do cobre esta alterado nas epilepsias, o autor estudou sob que forma essa alteracao se manifesta e, mediante o uso de curare em pacientes mentais submetidos ao eletrochoque, a influencia da hiperatividade muscular propria da crise convulsiva sobre o metabolismo do cobre. Alem disso, o autor estudou as correlacoes entre sexo e idade dos pacientes epilepticos, de um lado, e cupremia e cuprorraquia, do outro, e fez a correlacao entre os niveis de cobre do soro e do LCR desses pacientes. Nos pacientes epilepticos (84) foram colhidas amostras de sangue (81 casos) e de LCR (66 casos) em periodo intercritico para dosagem do cobre total. Nos pacientes mentais (32) foram colhidas amostras de sangue antes e imediatamente apos crise convulsiva determinada pelo eletrochoque simples (22 casos) para dosagem de ceruloplasmina, e imediatamente apos eletrochoque sob acao de curare (10 casos) para dosagem do cobre total. Os resultados foram submetidos a analise estatistica, tendo o autor chegado as seguintes conclusoes: 1) o nivel de cobre do sangue e do LCR dos pacientes epilepticos nao depende do sexo nem da idade; 2) o teor de cobre do LCR esta correlacionado com o do sangue nos pacientes epilepticos; 3) a supressao, mediante o uso de substância curarizante, das manifestacoes musculares da crise produzida pelo eletrochoque acarreta queda nao significativa do nivel de cobre do sangue; 4) a queda do nivel de cobre do sangue apos convulsoes determinadas pelo eletrochoque depende da hiperatividade muscular que caracteriza a crise convulsiva; 5) a queda do nivel de cobre do sangue apos convulsoes determinadas pelo eletrochoque depende principalmente do cobre de reacao direta; 6) a queda dos niveis de cobre do sangue apos convulsoes determinadas pelo eletrochoque e devida a pas* sagem desse elemento para os espacos intracelulares.

https://www.scielo.br/pdf/anp/v24n4/01.pdf

Cooper metabolism in the epilepsies

Copper sulfate poisoning.

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Copper sulfate poisoning.