2018 Vol. 3 No. 1: 2 Editorial DOI: 10.21767/2473-6457.10021 iMedPub Journals ht tp://journals.imedpub.com Journal of Heavy Metal Toxicity and Diseases ISSN 2473-6457 1 © Under License of Creative Commons Attribution 3.0 License | This article is available in: http://heavy-metal-chelation-therapy.imedpub.com/archive.php Introducton Copper Sulphate, CuSO 4 , is an inorganic compound, a potent oxidant, with a long history of use especially as a fungicide, bactericide and also a killer for smaller animals like snails for agriculture. The heavy metal, Copper (Cu) is an essental mineral although in excess is very harmful [1,2]. Copper sulphate can be available as powder, crystals or liquids and can be exposed by skin contact, inhalaton or by ingeston in the way of self harm or by accident. Copper causes damage to the cell membranes of the tssue cells making them swollen and causes cell death [2]. Red blood cells (causing haemolysis), myocytes (causing rhabdomyolysis) and hepatocytes (causing acute hepatts) are the commonest tssues afected [3]. Once absorbed copper occur in plasma as ceruloplasmin (Cp) bound to protein and excreted largely in faeces. It has a biological half-life (BH) of 13-33 days. When in excess it may get deposited mainly in the liver [4]. Plasma level of copper and other reference ranges related to copper metabolism in human is as follows; this data is adapted from Medscape artcle on Copper by Joshua Sloan- htps:// emedicine.medscape.com/artcle/2087780-overview Free serum copper: 1.6-2.4 μmol/L or 10-15 μg/dL Total copper: 10-22 μmol/L or 63.7-140.12 μg/dL Serum ceruloplasmin: 2.83-5.50 μmol/L or 18-35 μg/dL 24-hour urine copper 0.3-0.8 μmol or 20-50 μg Liver copper 0.3-0.8 μmol/g of tssue or 20-50 μg/g of tssue Copper Sulphate Poisoning (CSP) is rare, but a signifcant entty due to its higher risk of mortality even with smaller doses of ingeston. Features of toxicity can manifest even with a dosage of 1 g and dose of 10-20 g could even be lethal [5]. However clinical manifestatons and complicatons likely depend on other factors like, tme taken to seek medical atenton, quality of medical care one would receive, especially at emergency care and patent’s medical background. This artcle partcularly concentrates on clinical manifestatons and management of CSP in a more illustrated manner, to provide a guideline to the clinician. Signs and Symptoms There is mult-organ involvement with wide range of severity of each organ involved. Therefore clinical syndrome one would present will fall in to a large spectrum of possibilites. 1. Exposure related signs and symptoms Skin contact – irritaton, allergy if the person is allergic to compound. Eye – irritaton Inhalaton – breathing difculty Ingeston – nausea, vomitng and diarrhoea. Vomitus and diarrhoea can be greenish or bluish in colour [1]. 2. Symptoms due to erosive gastropathy Corrosive injury to gastric mucosa – epigastric pain and tenderness, nausea, vomitng Mucosal erosions or ulcers causing upper gastro-intestnal bleeding – haematemesis and malaena 3. Intravascular haemolysis Oxidatve damage to red cell membrane causes acute haemolysis – icterus, dark urine (Haemoglobinuria) and pallor. 4. Methaemoglobinaemia – cyanosis Absorbed Cu 2+ ions oxidises Fe 2+ to Fe 3+ ions in Hb generatng Methaemoglobin. These carry less Oxygen than normal Hb. Further, the hybrid Hb (ferri-ferro Hb) Clinical Features of Acute Copper Sulphate Poisoning Received: July 09, 2018; Accepted: July 10, 2018; Published: July 17, 2018 Champika Gamakaranage * Ministry of Health, Sri Lanka *Corresponding author: Champika Gamakaranage  champikasri@gmail.com Consultant Physician, Ministry of Health, Sri Lanka. Citaton: Gamakaranage C (2018) Clinical Features of Acute Copper Sulphate Poisoning. J Heavy Met Toxicity Dis Vol.3 No.1:2.