Saudi Journal of Kidney Diseases and Transplantation

: 2018  |  Volume : 29  |  Issue : 3  |  Page : 741--742

Acute kidney injury due to mothball poisoning: Indian pediatric cases

Beuy Joob1, Viroj Wiwanitkit2,  
1 Sanitation 1 Medical Academic Center, Bangkok, Thailand
2 Department of Tropical Medicine, Hainan Medical University, Haikou, China; Department of Community Medicine, Dr. D. Y. Patil University, Mumbai, Maharashtra, India

Correspondence Address:
Dr. Beuy Joob
Sanitation 1 Medical Academic Center, Bangkok

How to cite this article:
Joob B, Wiwanitkit V. Acute kidney injury due to mothball poisoning: Indian pediatric cases.Saudi J Kidney Dis Transpl 2018;29:741-742

How to cite this URL:
Joob B, Wiwanitkit V. Acute kidney injury due to mothball poisoning: Indian pediatric cases. Saudi J Kidney Dis Transpl [serial online] 2018 [cited 2022 Jan 16 ];29:741-742
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Full Text

To the Editor,

Ekambaram et al reported an interesting case of acute kidney injury (AKI) due to mothball poisoning.[1] Ekambaram et al noted that “although there have been previous reported cases of mothball poisoning causing hemolysis, there are no reported cases of AKI in children from India.[1]” Indeed, renal problem due to mothball toxicity is not common and has been sporadically reported worldwide. We would like to draw attention that the note by Ekambaram et al might not correct. At least, there is one previous report on AKI in an Indian boy by Deo et al.[2] Therefore, the case by Ekambaram et al is not the first Indian child with acute renal problem due to mothball poisoning. Indeed, the problem might be more common but underreported. In the developing countries, the mothball is widely used and there is usually no concern on safety.[3]

Conflict of interest: None declared.

Author's Reply

To the Editor,

I have submitted my manuscript (September 2015) and the revised version (December 2015) to the journal was finally accepted in December 2015 but was published only in November 2017. The article quoted by Mr. Beuy Joob was published in May 2016. Hence, to the best of my knowledge, I consider my report as the first one on an Indian boy child with this poisoning.

The age of the boy in the article published in May 2016 is 15 years (adolescent male). Our case record is on a two-year-old child. At this age, the history of ingestion or contact with mothballs is not forthcoming. Hence, it is necessary to remind ourselves that an inquiry for toxic ingredients should be made.

Mothballs are freely available in developing countries and are not properly labeled with “warnings” as quoted in my reference 15. I still consider that consumers (not uncommonly noninstitutional practitioners) are not aware of the toxic effects of mothballs and do not even come up with history during crisis as they are ignorant about its side effects. Hence, I feel it is difficult to accept that mothballs are safe and there is no concern for safety as quoted by Mr. Beuy Joob. I still consider that usage of mothballs should be with caution to prevent hazardous side effects.

In India, it is a common practice to pack children's dresses with mothballs which is also not a safe procedure.

Dr. Sudha Ekambaram,

Department of Pediatric Nephrology, Mehta Children's Hospital, Chennai, Tamil Nadu, India.

E-mail: [email protected]


1Ekambaram S, Chandan Kumar KM, Mahalingam V. Acute kidney injury: A rare complication of mothball (naphthalene) poisoning. Saudi J Kidney Dis Transpl 2017;28: 1412-5.
2Deo P, Sahu KK, Dhibar DP, Varma SC. Naphthalene ball poisoning: A rare cause of acquired methaemoglobinaemia. BMJ Case Rep 2016;2016. pii: bcr2016215102.
3Bates N. Mothball poisoning. Emerg Nurse 2002;10:24-8.