DOI: 10.12890/2026_006465

The effect of pyrethroid ingestion on butyrylcholinesterase level

Authors

  • Emile Al Katrib Department of Internal Medicine, Faculty of Medicine, University of Balamand, Dekweneh-Beirut, Lebanon
  • Ayman Karroum Department of Internal Medicine, Faculty of Medicine, University of Balamand, Dekweneh-Beirut, Lebanon
  • Radwan Zaidan Department of Pulmonary, Faculty of Medicine, University of Balamand, Dekweneh-Beirut, Lebanon
  • Mirna Fares Department of Pulmonary, Faculty of Medicine, University of Balamand, Dekweneh-Beirut, Lebanon

mirnafarespub@gmail.com

Keywords

Pyrethroid toxicity, butyrylcholinesterase level, acetylcholinesterase level, organophosphate comparison, toxicological effects

Abstract

We report a 45-year-old man who experienced dyspnoea, severe chest pain followed by decreased level of consciousness, and seizure-like symptoms requiring sedation and intubation. The level of high-sensitivity troponin was elevated. The patient was diagnosed in an outside institution with acute coronary syndrome along with infectious meningitis based on studies performed on cerebrospinal fluid (CSF). The patient was transferred to our hospital for further management. Cardiac ultrasound showed dilated cardiomyopathy with decreased ejection fraction. Significant coronary stenosis was excluded by coronary angiography and a polymerase chain reaction neuro-panel on the CSF came back negative. After exclusion of ACS and meningitis, detailed history taking showed that the patient´s office at work had been treated with an insecticide. The product used turned out to be deltamethrin, a type II pyrethroid. The butyrylcholinesterase (BChE) level was low. Studies have shown that deltamethrin produces neurotoxicity and cardiovascular complications; however, the effect of deltamethrin on the BChE level and the development of non-ischemic cardiomyopathy remains unclear.

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References

  1. Ahamad A, Kumar J. Pyrethroid pesticides: an overview on classification, toxicological assessment and monitoring. J Hazard Mater Adv 2023;10:100284. doi: 10.1016/j.hazadv.2023.100284
  2. Holynska-Iwan I, Szewczyk-Golec K. Pyrethroids: How They Affect Human and Animal Health? Medicina (Kaunas) 2020;56:582. doi: 10.3390/medicina56110582
  3. Alaa El-Din A, Abdallah Abouhashem A, Abdallah El-Shafei D, S Abouhashem N, Mostafa H. Individual and mixture effect of deltamethrin and dimethoate on liver: a biochemical, histopathological, immunohistochemical, and genotoxic study. Egypt J Forensic Sci Appl Toxicol 2022;22:23–38. doi: 10.21608/ejfsat.2021.48422.1176
  4. Al-Omar MS, Naz M, Mohammed SAA, Mansha M, Ansari MN, Rehman NU, et al. Pyrethroid-Induced Organ Toxicity and Anti-Oxidant-Supplemented Amelioration of Toxicity and Organ Damage: The Protective Roles of Ascorbic Acid and alpha-Tocopherol. Int J Environ Res Public Health 2020;17:6177. doi: 10.3390/ijerph17176177
  5. Cao Z, Shafer TJ, Murray TF. Mechanisms of pyrethroid insecticide-induced stimulation of calcium influx in neocortical neurons. J Pharmacol Exp Ther 2011;336:197-205. doi: 10.1124/jpet.110.171850
  6. Bao W, Liu B, Simonsen DW, Lehmler HJ. Association Between Exposure to Pyrethroid Insecticides and Risk of All-Cause and Cause-Specific Mortality in the General US Adult Population. JAMA Intern Med 2020;180:367-374. doi: 10.1001/jamainternmed.2019.6019
  7. Scheepers LD, Freercks R, Merwe EV. Acute cypermethrin and other pyrethroid poisoning - An organophosphate-like poisoning: A case report and review. Toxicol Rep 2023;11:107-110. doi: 10.1016/j.toxrep.2023.06.013
  8. Lin CC, Lai SY, Hu SY, Tsan YT, Hu WH. Takotsubo cardiomyopathy related to carbamate and pyrethroid intoxication. Resuscitation 2010;81:1051–1052. doi: 10.1016/j.resuscitation.2010.04.035

Published

2026-04-22

Issue

Vol. 13 No. 5 (2026)

Categories

How to Cite

1.
Al Katrib E, Karroum A, Zaidan R, Fares M. The effect of pyrethroid ingestion on butyrylcholinesterase level. EJCRIM [Internet]. 2026 Apr. 22 [cited 2026 Nov. 3];13(5). Available from: https://ejcrim.com/index.php/ejcrim/article/view/6465

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