This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by KüçükardalI, Y. Articles by Danaci, M. Search for Related Content PubMed PubMed Citation Articles by KüçükardalI, Y. Articles by Danaci, M. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB CYCLONITE Social Bookmarking                         What's this?

Accidental Oral Poisoning Caused by Rdx (Cyclonite): A Report of 5 Cases

Yaar KüçükardalI, MD

H. Volkan Acar, MD

Sezai Özkan, MD

Selim Nalbant, MD

Yusuf Yazgan, MD

E. Murat Atasoyu, MD

Özcan Keskin, MD

Alian Naz, PhD

Nevzat Akyatan, MD

Merih Gökben, MD

Mehmet Danaci, MD

The explosive RDX (hexogen, cyclonite) is usually used for the production of C-4 explosive. The rare occurrence of accidental and intentional RDX intoxications has been reported during manufacturing process or in wartime. In this article, the authors report 5 cases of accidental oral RDX poisoning. On admission, observed signs and symptoms included repetitive generalized tonic-clonic convulsions, postictal coma, lethargy, confusion, hyperreflexia, postictal amnesia, nausea, vomiting, abdominal tenderness, sinusal tachycardia, dysrhythmia with frequent ventricular premature beats, generalized muscle spasms, and myoclonus. Leukocytosis, mild anemia, methemoglobinemia, elevated levels of blood glucose, serum aspartate transaminase, alanine transaminase, lactic dehydrogenase, creatine phosphokinase, amilase, hypokalemia, metabolic acidosis, proteinuria, glucosuria, and myoglobinuria were also noted. Plasma RDX concentrations were 268 to 969 ng/mL at 3 hours of ingestion. For management, supportive and symptomatic measures were taken. Whole-bowel irrigation might have been an effective therapeutic procedure due to probable slow gastrointestinal absorption of RDX. Three patients who developed severe metabolic acidosis underwent urgent hemodialysis. All patients were discharged 7 to 21 days after admission without any sequelae. Plasma RDX levels were strongly correlated with the clinical and laboratory manifestations. The available toxicological data on this rare accidental poisoning are reviewed in light of the literature.

Key Words: RDX (cyclonite, hexogen) • oral poisoning • accidental • convulsion

Journal of Intensive Care Medicine, Vol. 18, No. 1, 42-46 (2003)
DOI: 10.1177/0885066602239123


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?