Renal haemorrhage

Occurs in all parts of the camphor tree Cin-namomum camphora. White solid, penetrating odour sublimes appreciably at ambient temperature readily volatile in steam. Teaspoonful of camphorated oil said to produce serious toxic effects in an adult. Children 1 g camphor profuse dermal, gastric and renal haemorrhaging. CNS deterioration, death. Liver and kidney fatty degeneration. Rapid absorption from gut lipid-soluble. Convulsions status epilepticus. 

Paracetamol overdose is most likely to cause hepatic necrosis and to a lesser extent renal necrosis. Hepatic necrosis is maximal within 3-4 hours of ingestion and may lead to encephalopathy, haemorrhage, hypoglycaemia, cerebral oedema and death. Acetylcysteine tends to protect the liver if given within 10-12 hours of paracetamol poisoning. The maximum adult dose of paracetamol is 4 g in 24 hours. 

Orotic acid added to rat diet also provokes an. excessive biosynthesis of porphyrins in liver, erythrocytes and bone marrow. Administration of adenine monophosphate (AMP) counteracted this effect of orotic acid intoxication [165]. Haemorrhagic renal necrosis in rats, caused by choline deficiency, can be relieved by orotic acid [166], Simultaneous supplementation of the diet with adenine does not influence the protective effect of orotic acid. It has been suggested that orotic acid may lower the body requirement for choline through a metabolic interaction—orotic acid may stimulate the cytidine phosphate choline pathway of lecthin biosynthesis [166]. 

Adverse effects include nausea, vomiting, headache, fever, abdominal pain, hyperglycemia leading to coma, hypersensitivity, renal damage, coagulation defects, thrombosis, CNS depression or hyperexcitability and acute haemorrhagic pancreatitis. 

Nausea, vomiting and abdominal pain. Excessive doses may cause profuse diarrhoea, gastrointestinal haemorrhage, rashes, renal and hepatic damage... 

The symptoms of acute and chronic poisoning by arsenic have been described by Rentoul and Smith [10], Davidson and Henry [11] and Fowler [12]. Acute symptoms include gastrointestinal damage, convulsions and haemorrhage at autopsy, fatty degeneration of the liver and kidneys is frequently noted. Acute inhalation of arsine is followed by extensive haemolysis, haemoglobinuria and death from renal failure. 

Complications Acute liver failure, arterioportal fistula formation, oesophageal varices (15) and pulmonary hypertension have been reported as complications. In most cases, the cause of death is anorexia with tumour cachexia, accompanied by signs of circulatory and renal failure. Occasionally, there is intraperitoneal haemorrhage, portal vein thrombosis (138,146) and tumour rupture with formation of haemorrhagic ascites. (121)... 

Lau G. latrogenically-related, fatal haemorrhage occurring in end-stage renal failure a series of three cases. Forensic Sci Int 1995 73(2) 117-24. 

Animals became restles s and developed piloerec-tion within 5 min of dosing. There then developed salivation, rapid shallow breathing, extensor spasms and convulsions. In survivors, these effects subsided within 24 h and no abnormalities were seen on sacrifice at 21 days. Animals that died usually did so within 1 to 18 h, although a few survived for 2 to 9 days. Animals that died showed congestion of the liver, small intestine and lungs, with scattered patches of inter-and intra-alveolar haemorrhages. Small circumscribed foci of acute renal tubular necrosis were occasionally seen. 

Kumar et al. (1994) exposed mice to an average CR concentration of 1008 mg m 3 daily for 15 minaday for lOdays. At5days, lungs demonstrated minimal alveolar haemorrhage and after 10 days there was moderate alveolar haemorrhage and alveolar capillary congestion and a few foci of renal cortical necrosis. 

On admission, some 36 h after the incident, local necrotic lymphadenopathy was present and gastrointestinal haemorrhage ensued with hypo-volaemic shock and renal failure death occurred on the third day. At autopsy, there was evidence of pulmonary oedema and haemorrhagic necrosis of the small bowel haemorrhages were observed in the lymph nodes local to the injection site, in the myocardium, testicles and pancreas. 

Goodpasture disease/syndrome. An autoimmune pulmonary-renal syndrome characterized by pulmonary haemorrhage, glomerulonephritis, and production of autoantibody to glomerular... 

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