Daily Toxicology Literature Report (11/26/2025)

Daily Medical Toxicology Literature Report

Date: 25 November 2025

Source: PubMed saved search – poisoning[Title]

1. Superwarfarin Rodenticide Poisoning due to Consumption of Exotic Animals

Citation: Sadek B, Dasmarinas C, Patel I, Bowman L, Xie P, Irons E, Jang A. Case Rep Hematol. 2025;2025:9981550.

Link: https://pubmed.ncbi.nlm.nih.gov/41293559/

Type: Human case report (superwarfarin, foodborne exposure)

Keywords: superwarfarin, long-acting anticoagulant rodenticide, exotic meat, coagulopathy

Summary:

A patient developed clinically significant coagulopathy after consuming exotic animals later found to be contaminated with long-acting anticoagulant rodenticides (superwarfarins). Management required prolonged high-dose vitamin K therapy and close monitoring of coagulation parameters.

Clinical / toxicovigilance takeaway:

Superwarfarin poisoning may occur via contaminated game or exotic meat, not only through direct access to rodenticide products. In unexplained coagulopathy with a history of wild/exotic animal consumption, clinicians should consider long-acting anticoagulant rodenticides.

2. Analysis of Suspected Food Poisoning Incidents in Riyadh, Saudi Arabia: An Epidemiological Perspective

Citation: Alajlan AA, Almansour A, Alhumaidan OA, Alwetaid MY, Al-Shehri AA, Alajel SM, Almusa M, Albaridi NA. Int J Microbiol. 2025;2025:4803121.

Link: https://pubmed.ncbi.nlm.nih.gov/41293040/

Type: Epidemiologic study (foodborne disease surveillance)

Keywords: food poisoning, outbreak investigation, surveillance, Saudi Arabia

Summary:

Using surveillance data from Riyadh, this study characterizes suspected food poisoning incidents by age, sex, implicated foods, setting (home vs commercial), and seasonality. The authors highlight frequent links to improper storage, inadequate cooking, and poor food-handling practices, and emphasize the importance of structured reporting systems.

Clinical / toxicovigilance takeaway:

Routine analysis of reported food poisoning events helps identify high-risk foods, contexts, and behaviors, informing targeted public-health interventions and improved food safety regulations.

3. Abnormal Intrinsic Brain Functional Network Dynamics in Delayed Encephalopathy after Carbon Monoxide Poisoning

Citation: Yi J, Lv H, He L, Tan Y. Sci Rep. 2025;15:41998.

Link: https://pubmed.ncbi.nlm.nih.gov/41290957/

Type: Neuroimaging research (resting-state fMRI, human)

Keywords: carbon monoxide, delayed encephalopathy, functional connectivity, brain networks

Summary:

In patients with delayed encephalopathy after carbon monoxide poisoning (DEACMP), resting-state fMRI revealed abnormal temporal dynamics in large-scale brain networks, including default mode and frontoparietal networks, compared with healthy controls. These alterations suggest disrupted integration and segregation of intrinsic brain networks as a substrate for cognitive and neuropsychiatric sequelae.

Clinical / toxicovigilance takeaway:

DEACMP reflects network-level brain dysfunction that may not be fully appreciated on structural imaging alone. Survivors of significant CO poisoning warrant long-term cognitive and neuropsychiatric follow-up, reinforcing the importance of CO prevention and early treatment.

4. Clinical Presentation and Management of Ethoxy-Modified Trisiloxane Surfactant Poisoning

Citation: Vong IC, Leong HI, Lei J. Cureus. 2025;17(10):e95116.

Link: https://pubmed.ncbi.nlm.nih.gov/41287691/

Type: Human case report (adolescent, intentional ingestion)

Keywords: agricultural surfactant, silicone-based adjuvant, herbicide, intentional self-poisoning

Summary:

A 13-year-old girl intentionally ingested an herbicide containing an ethoxy-modified trisiloxane surfactant, a silicone-based agricultural spreading agent with very limited human toxicity data. She developed mild gastrointestinal symptoms but remained hemodynamically stable and recovered fully with observation and supportive care.

Clinical / toxicovigilance takeaway:

Available data suggest low acute systemic toxicity from ethoxy-modified trisiloxane surfactants at modest ingestion volumes, but human experience remains sparse. Such cases should still prompt careful monitoring and, given the context, formal mental-health evaluation.

5. Adult Lead Poisoning Linked to Non-prescription Ayurvedic Medication (Germany)

Citation: Acharya-Büch R, Ivaki P, Jeitler M, Murthy V, Kessler CS. Complement Med Res. 2025;Online ahead of print.

Link: https://pubmed.ncbi.nlm.nih.gov/41284577/

Type: Adult case report (heavy metal toxicity)

Keywords: lead poisoning, Ayurvedic medicine, complementary medicine, Europe

Summary:

A 65-year-old woman in Germany developed symptomatic lead poisoning after using non-prescription Ayurvedic preparations obtained from an unlicensed practitioner. Clinical features included anemia and neurological complaints, with elevated blood lead levels and improvement following cessation of the products and chelation.

Clinical / toxicovigilance takeaway:

Traditional or “natural” remedies, including Ayurvedic products used in Western countries, remain important potential sources of lead exposure. In adults with unexplained anemia, neuropathy, or constitutional symptoms, clinicians should inquire about complementary/alternative medications and consider blood lead testing.

6. Transition Metal Doping for Improved Detection of Paralytic Shellfish Poisoning Toxins

Citation: Vale P. Food Addit Contam Part A. 2025;Online ahead of print.

Link: https://pubmed.ncbi.nlm.nih.gov/41283889/

Type: Analytical methods paper (marine biotoxins)

Keywords: paralytic shellfish poisoning, saxitoxin, HPLC-FLD, transition metals

Summary:

This study explores the use of transition metals (e.g., iron, zinc) to enhance the fluorescence signal in the AOAC pre-column oxidation method for paralytic shellfish toxins (saxitoxin and congeners). Optimized “metal-doped” conditions improve analytical sensitivity and reduce matrix interference for certain toxin subgroups in shellfish samples.

Clinical / toxicovigilance takeaway:

More sensitive detection of paralytic shellfish toxins strengthens upstream environmental and food monitoring, enabling earlier identification of contaminated shellfish lots and potentially reducing human cases of paralytic shellfish poisoning.

7. Nephrotic Syndrome Caused by Mercury in Freckle-Removing Cream

Citation: Wu C, Liu D. Front Med (Lausanne). 2025;12:1651441.

Link: https://pubmed.ncbi.nlm.nih.gov/41282025/

Type: Human case report (cosmetic-related heavy metal toxicity)

Keywords: mercury poisoning, cosmetic cream, nephrotic syndrome, membranous nephropathy

Summary:

A 33-year-old woman presented with fatigue and peripheral edema and was diagnosed with nephrotic syndrome due to membranous nephropathy. Investigations revealed markedly elevated urinary mercury and use of a freckle-removing cream containing extremely high concentrations of mercury, with clinical improvement after discontinuing the product and appropriate therapy.

Clinical / toxicovigilance takeaway:

Mercury-containing cosmetic products, particularly skin-lightening or freckle-removing creams, can present primarily as kidney disease (proteinuria, nephrotic syndrome) rather than classic neuropsychiatric toxicity. Exposure history for cosmetic and traditional skin products is crucial in otherwise “idiopathic” nephrotic syndromes.

8. Experience and Reflection on the Treatment of Calcium Channel Blocker Poisoning in Elderly Patients

Citation: Ou L, Lin J, Zhang H, Xu X, Lai S. Clin Case Rep. 2025;13(11):e71374.

Link: https://pubmed.ncbi.nlm.nih.gov/41280266/

Type: Two elderly case reports (cardiotoxic overdose)

Keywords: calcium channel blockers, high-dose insulin euglycemic therapy, vasopressors, extracorporeal support, elderly

Summary:

The authors report two elderly patients with severe calcium channel blocker poisoning who experienced rapid hemodynamic compromise and required early high-dose insulin euglycemic therapy (HIET), vasopressor support, and continuous renal replacement therapy. Individualized hemodynamic management and timely escalation to advanced therapies were critical for stabilization.

Clinical / toxicovigilance takeaway:

Calcium channel blocker poisoning in older adults carries high mortality risk and warrants early aggressive management, including prompt HIET and consideration of extracorporeal support. In toxicovigilance systems, CCB overdoses in patients >60 years should be treated as high-acuity events.

9. Serum Glucose/Potassium Ratio and Leucocyte Glucose Index as Predictors of Poor Outcomes in Acute Clozapine Poisoning

Citation: Elsharkawy RE, Lashin HI, Mohammed HS. Toxicol Res (Camb). 2025;14(6):tfaf162.

Link: https://pubmed.ncbi.nlm.nih.gov/41278082/

Type: Retrospective cohort (n = 215) with prognostic score development

Keywords: clozapine overdose, risk stratification, glucose/potassium ratio, leucocyte glucose index

Summary:

In 215 cases of acute clozapine poisoning, the authors assessed the serum glucose/potassium ratio and leucocyte glucose index as prognostic markers. Combined with clinical variables (e.g., blood pressure, GCS, pH, ECG findings), these indices were used to construct a risk score with good discriminative ability for predicting poor outcomes, including ICU admission, mechanical ventilation, and mortality.

Clinical / toxicovigilance takeaway:

Simple derived lab indices (glucose/potassium ratio and leucocyte glucose index) may help stratify risk in clozapine overdoses and guide decisions on level of care and monitoring intensity. External validation across other centers would help determine generalizability.

10. Pattern of Pharmaceutical Poisoning in the Perak Population (2019–2021)

Citation: Gatera VA, Mat Rani NNI, Bin Ismail MF, Mohamed Khan HR, Nor Afendi NSH, Samsudin S, Mohd Samin AS, Rani NAA, Kamaruzaman NA. Risk Manag Healthc Policy. 2025;18:3665–3674.

Link: https://pubmed.ncbi.nlm.nih.gov/41277908/

Type: Retrospective epidemiologic study (pharmaceutical poisonings, n = 348)

Keywords: pharmaceutical poisoning, self-poisoning, psychiatric medications, Malaysia

Summary:

This study analyzes 348 pharmaceutical poisoning cases reported from Perak, Malaysia (2019–2021), focusing on age, sex, and mode of poisoning. Working-age adults accounted for nearly half of the cases, with psychiatric medications being the most frequent drug class. Intentional poisoning was more common among women and patients using psychotropics, whereas accidental exposures were more frequent in younger males and with topical products such as calamine lotion.

Clinical / toxicovigilance takeaway:

Psychiatric medications play a central role in intentional self-poisoning, while unsafe storage and use of topical/OTC products contribute to accidental exposures. Age- and sex-specific prevention strategies and mental-health interventions are essential for reducing the burden of pharmaceutical poisoning.