Tetramine poisoning

CM Chau, AKH Leung, IKS Tan
Intensive Care Unit, North District Hospital, Sheung Shui, Hong Kong


We report on two patients who presented with status epilepticus due to ingestion of rat poison containing tetramine. Both had eaten the same meal, subsequently presumed to be the source of the poison. Physical examination and investigation were unremarkable and diagnosis was based on patient history. Seizures were ultimately controlled with ketamine, after unsuccessful attempt of benzodiazepine and sodium thiopentone. One week after poisoning, both patients underwent one session of high-volume haemofiltration followed by charcoal haemoperfusion to eliminate the toxin from the body. Plasma tetramine levels then decreased from 0.95 ug/mL to 0.35 ug/mL and from 0.53 ug/mL to 0.40 ug/mL, respectively.

Hong Kong Med J 2005;11:511-4

Key words: Hemofiltration; Hemoperfusion; Ketamine; Status epilepticus; Tetramethylenedisulfotetramine