R Agarwal1, R Srinivas, A N Aggarwal, D Gupta. 1. Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Sector-12, Chandigarh, India. ritesh@indiachest.org
Abstract
INTRODUCTION: Paraquat poisoning is an uncommon entity in India. We report our experience of managing five patients with paraquat poisoning using immunosuppressive therapy. METHODS: Retrospective analysis of 84 patients admitted with a diagnosis of poisoning over the last eight years was performed. The data were presented in a descriptive fashion. RESULTS: Five (5.9 percent) out of the 84 patients were admitted with a diagnosis of paraquat poisoning. All patients were mechanically ventilated. All patients had hepatic failure with median peak bilirubin being 22.1 +/- 15.1 mg/dL (range 8.4-45.5). Four of the five patients had renal failure (median peak creatinine 3.8 +/- 1.5 mg/dL; range 3.4-11.1) requiring renal replacement therapy. All patients were treated with intravenous methylprednisolone 15 mg/kg/day for three consecutive days and intravenous cyclophosphamide 10 mg/kg/ day for two consecutive days, followed by intravenous dexamethasone 4 mg thrice a day until recovery or death. Two out of the five patients survived. Three died because of severe acute respiratory distress syndrome and multiorgan dysfunction syndrome. CONCLUSION: Paraquat poisoning is an uncommon entity in India, and is associated with a high mortality rate. There is a potential role for immunosuppressive therapy in patients with moderate to severe poisoning.
INTRODUCTION:Paraquat poisoning is an uncommon entity in India. We report our experience of managing five patients with paraquat poisoning using immunosuppressive therapy. METHODS: Retrospective analysis of 84 patients admitted with a diagnosis of poisoning over the last eight years was performed. The data were presented in a descriptive fashion. RESULTS: Five (5.9 percent) out of the 84 patients were admitted with a diagnosis of paraquat poisoning. All patients were mechanically ventilated. All patients had hepatic failure with median peak bilirubin being 22.1 +/- 15.1 mg/dL (range 8.4-45.5). Four of the five patients had renal failure (median peak creatinine 3.8 +/- 1.5 mg/dL; range 3.4-11.1) requiring renal replacement therapy. All patients were treated with intravenous methylprednisolone 15 mg/kg/day for three consecutive days and intravenous cyclophosphamide 10 mg/kg/ day for two consecutive days, followed by intravenous dexamethasone 4 mg thrice a day until recovery or death. Two out of the five patients survived. Three died because of severe acute respiratory distress syndrome and multiorgan dysfunction syndrome. CONCLUSION:Paraquat poisoning is an uncommon entity in India, and is associated with a high mortality rate. There is a potential role for immunosuppressive therapy in patients with moderate to severe poisoning.
Authors: Analía Czerniczyniec; E M Lanza; A G Karadayian; J Bustamante; S Lores-Arnaiz Journal: J Bioenerg Biomembr Date: 2015-09-09 Impact factor: 2.945
Authors: Kondle Raghu; Vidavalur Mahesh; Parri Sasidhar; Polam R Reddy; Vajja Venkataramaniah; Amit Agrawal Journal: J Family Community Med Date: 2013-09
Authors: Harika Cherukuri; K Pramoda; D Rohini; Girish Thunga; K Vijaynarayana; N Sreedharan; Muralidhar Varma; Vinay Pandit Journal: Toxicol Int Date: 2014-05