Fatal intravascular haemolysis due to copper sulfate poisoning: insights and literature review

This case report is of a young woman who presented to a tertiary hospital after ingestion of 30 g copper sulfate. On admission she complained of abdominal pain, nausea and vomiting. Examination showed tenderness in the epigastric and right hypochondriac regions along with tender hepatomegaly. Initial management consisted of gastric lavage, administration of activated charcoal and chelation therapy. Although her vital signs were stable at admission, her condition rapidly deteriorated over time. By the second day she had developed acute kidney injury, severe intravascular haemolysis and significant methaemoglobinaemia necessitating haemodialysis and red blood cell transfusions. Despite aggressive treatment, she died 48 hours after presentation. This case highlights the fulminant nature of copper sulfate poisoning, marked by rapid progression to hepatic and renal failure and massive intravascular haemolysis. Prompt recognition and aggressive multidisciplinary interventions are essential to improve outcomes in such critical cases.