Decrease in butyrylcholinesterase accompanied by intermediate-like syndrome after massive ingestion of a glyphosate-surfactant

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Abstract

An 86-year-old woman intentionally drank approximately 300 mL of a glyphosate-surfactant. She was found with consciousness disturbance and experienced several vomiting episodes. On arrival, serum biochemistry revealed a decreased level of butyrylcholinesterase (B-CHE) [11 (normal range: 180-450) IU/L]. Later, her B-CHE level further decreased to single-digit values, and she became comatose with involuntary movement and an increase in muscle tone. Her consciousness level and muscle tone improved with the recovery of her B-CHE level. Physicians should be alert for the occurrence of intermediate syndrome when the B-CHE levels of patients who have consumed a massive amount of glyphosate-surfactant show a prolonged decrease.

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Takeuchi, I., Yanagawa, Y., Nagasawa, H., Jitsuiki, K., Madokoro, S., Takahashi, N., … Omori, K. (2019). Decrease in butyrylcholinesterase accompanied by intermediate-like syndrome after massive ingestion of a glyphosate-surfactant. Internal Medicine, 58(20), 3057–3059. https://doi.org/10.2169/internalmedicine.2562-18

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