구서제 RH-787(N-3-Pyridylmethyl-N-p-nitrophenylurea)이 췌도에 미치는 영향

Abstract

RH-787 (N -S-pvridy1methy1-N' <p-nitrophenylurea), a rodenticide, has been used in Korea since 1976 with subsequent increasing incidence of its human intoxication for the purpose of comitting suicide, but the pathogenesis of this drug-induced diabetes mellitus remains inconclusive. The authors herein presents an autopsy case of a 40-year-old female whose clinical course was reflected by a selective involvement of pancreatic islets as a target organ. p·cell cytolysis and loss of its granularity comprised a major pathologic alteration. To support and clarify the pathologic characteristics of the above autopsy case, an animal 'experiment was carried out by means of inducing acute RH-787 intoxication in rats. In animal group fed with 72.0 mg/kg (MLD,o x 4) the blood sugar levels before death elevated 2~3 times (up to 378 mg%) of control group and died within 24 hours, but in the other group with 1/3 of MLD50 for 2 times, its average elevation ranged 136~180mg%. Pancreatic lesions were basically identical to those seen in the autopsy case. featuring complete degranulation of p·cells or their cytolysis in Langerhans islets. It is of authors assumption that RH-787 affects selectively p-cells of pancreatic islets with similar mechanism to streptozotocin, resulting in acute hyperglycemic course.