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R B Leftwich

Publications and source records attributed to R B Leftwich.

3 recordsLinked to original sources

Dinitrophenol poisoning: a diagnosis to consider in undiagnosed fever.

A 32-year-old farmer had signs and symptoms of dinitrophenol poisoning after crop spraying with a herbicide containing derivatives of 2,4-dinitrophenol. Dinitrophenol causes toxicity by the uncoupling of oxidative phosphorylation in the mitochondria of cells throughout the body. In man the classic syndrome consists of lassitude, malaise, headache, increased perspiration, thirst, and dyspnea which may progress to hyperpyrexia, profound weight loss, respiratory failure, and death. Because dinitrophenol compounds are widely used, it is likely that some patients with unexplained fever have unrecognized dinitrophenol poisoning. Prompt recognition of the clinical manifestations of toxicity is vital for appropriate therapy. We describe a method for detection of dinitrophenol in plasma and urine.

Adult

Agranulocytosis during combined procainamide and phenytoin therapy.

We have presented two cases of agranulocytosis occurring in patients receiving a combination antiarrhythmic regimen. As multiple drug therapy for ventricular arrhythmias becomes more commonplace, increased scrutiny should be given to agents chosen, in an effort to prevent any possible adverse interactions. When future cases are encountered, the acetylator pheontype should be determined. This information would aid in assessing the predicative value of the acetylator phenotype in the development of agranulocytosis. Due to the inherent danger, neither patient was rechallenged with procainamide nor phenytoin.

Acetylation