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Closantel Poisoning Treated With Plasma Exchange

Michael J. Koziolek, MD1; Daniel Patschan, MD1; Herbert Desel, MD2; Manuel Wallbach, MD1; Josep Callizo, MD3
[+] Author Affiliations
1Department of Nephrology and Rheumatology, University Medical Center Göttingen, Georg-August-Universität, Göttingen, Germany
2GIZ-Nord Poisons Center, University Medical Center Göttingen, Georg-August-Universität, Göttingen, Germany
3Department of Ophthalmology, Georg-August-Universität, Göttingen, Germany
JAMA Ophthalmol. 2015;133(6):718-720. doi:10.1001/jamaophthalmol.2015.191.
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Plasma exchange (PE) is an extracorporeal therapy that separates and then removes plasma, aiming to remove pathogenic material from the patient. We describe a patient with visual impairment due to closantel poisoning. Because closantel binds to plasma albumin, we treated the patient with PE.

Article InformationCorresponding Author: Michael J. Koziolek, MD, Department of Nephrology and Rheumatology, University Medical Center Göttingen, Georg-August-Universität Göttingen, Robert-Koch-Str 40, D-37075 Göttingen, Germany (mkoziolek@med.uni-goettingen.de).

Published Online: March 5, 2015. doi:10.1001/jamaophthalmol.2015.191.

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Additional Contributions: Marcus Blum, MD, Eye Hospital, Helios Hospital Erfurt, Erfurt, Germany, and Nicolas Feltgen, MD, Department of Ophthalmology, Georg-August-Universität, Göttingen, Germany, collected clinical data; they received no compensation.

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Figure.
Visual Fields on Goldmann Perimetry

A, Visual fields on Goldmann perimetry at the first visit show a constriction of the outer margins and a relative scotoma in the central area. B, After 2 weeks, the outer margins improved and the sensitivity increased in the center. C, After 3 months, the visual fields recovered almost completely, with relative scotomas in the central 10°.

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