Endrin is a toxic chlorinated hydrocarbon that was formerly widely used as a pesticide and in various industries. It can enter the body through the gastrointestinal tract, skin or lungs. Endrin poisoning is typified by central nervous system dysregulation.
Endrin is an organochlorine, a substance that has been used in pesticides and manufacturing plants . Similar compounds include dieldrin and endosulfan   . Exposure is mainly either accidental or occupational and entails ingestion of contaminated food or water, absorption through the skin when in contact with contaminated soil for example, and inhalation of polluted air in industries. Symptoms usually resolve and patients fully recover after exposure has ceased, however, some cases of severe endrin poisoning (EP) are fatal.
Acute EP occurs unintentionally (although it can be deliberate), and mild exposure produces fewer complaints such as abdominal discomfort, headaches, and dizziness. Nausea and vomiting are also present. More severe signs are experienced with higher doses, this is exemplified by cardiac arrhythmias. As endrin mainly affects the central nervous system (CNS), multiple neurological disturbances can be noticed . The most frequent of these is generalized tonic-clonic seizures. These may commence abruptly, with no prodromes, minutes to days after exposure . They often recur over the course of a few days, and patients may exhibit episodes of altered mental status, such as confusion, and may be comatose. Repeated seizures contribute to fatalities by causing tissue hypoxia and acid-base derangement. Moreover, paresthesia, involuntary muscle movements, and gait instability have been reported . Endrin can directly cause significant respiratory depression. Rarer manifestations such as hyperthermia have been described. Some symptoms following acute intoxication, namely general body weakness, fatigue, dizziness, and anorexia, persist for a number of weeks. Electroencephalogram (EEG) changes may be reported up to 6 months after the latest exposure . Signs of chronic disease may include damage to the liver, lung, and kidneys.
Diagnosis is clinical and formulated by both anamnestic data and physical examination. It should be noted that the patient history serves to inquire about endrin exposure and, in addition, it is a tool for excluding organic causes of CNS dysfunction. Ensuing studies should be conducted with the same aim if the history is unclear. These include a basic metabolic panel, arterial blood gases, toxicology screen, liver function tests, urine microscopy culture and sensitivity and blood glucose testing. Certain values may be deranged due to organ dysfunction that can be made evident by hypoxemia, metabolic acidosis, hyperkalemia, raised creatinine levels, tachycardia or bradycardia, and increased serum bilirubin. A head computerized tomography (CT) scan and cerebrospinal fluid analysis may be advised. Chest X-rays are taken if poisoning occurred through inhalation. Abdominal X-rays are instrumental in detecting ingested pesticides containing endrin or other organochlorines .
Blood samples are, via chromatography, play an important role in the detection and measurement of organochlorines in the body. As there is a toxic threshold, it is crucial to note that a positive result may simply indicate exposure, and not endrin poisoning . The metabolism of endrin leads to the excretion of its metabolites in urine. The concentration of the latter may be measured, however this technique is preferentially employed in cases of chronic exposure.