Hydrogen Cyanamide (Dormex) toxicity: a rare case of acute fulminant hepatitis and coagulopathy

Introduction: Hydrogen cyanamide (Dormex), a widely used plant growth regulator, poses significant toxic hazards, particularly in low-resource agricultural regions. The ease accessibility of agricultural chemicals facilitates impulsive self-poisoning. Case report: We report a case of ۱۶-year-old female who intentionally ingested Dormex in a suicidal attempt. She was initially misdiagnosed as having organophosphate poisoning. The patient developed severe complications, including metabolic acidosis, disseminated intravascular coagulation (DIC), acute fulminant hepatitis, cerebral edema, and multi-organ failure. Aggressive supportive management was initiated, including N-acetylcysteine infusion, fresh frozen plasma, and mechanical ventilation. Her condition gradually improved, and she ultimately made a full recovery. Discussion: This case report adds to the sparse literature on intentional self-poisoning with hydrogen cyanamide related to occupational context, offering critical insight into its clinical presentation, and multisystem complications. It documents a rare complication of DIC and rapid clinical deterioration following ingestion, yet survival with prompt supportive management.Conclusion: This case highlights the high toxicity associated with hydrogen cyanamide ingestion and emphasizes the importance of early and accurate diagnosis, in addition to the aggressive supportive management. It also calls attention to the urgent need for regulatory measures, public health education, and safe storage practices in agricultural communities to prevent accidental or intentional exposures.

کلیدواژه ها:

Hydrogen cyanamide ، Self-poisoning ، occupational related ، Fulminant hepatitis ، Coagulopathy