Document Type : Case Report

Authors

1 Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

2 Obesity and eating habits research institute, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Introduction: Paraquat is one of the most widely used herbicides worldwide. It is quick-acting and non-selective, killing green plant tissue on contact. Paraquat poisoning is a critical condition with a high mortality rate due to its extreme toxicity, particularly with regard to its impact on lung health.
Case Presentation: This case report delineates the clinical progression and therapeutic interventions for a 33-year-old Iranian male who survived a substantial ingestion of paraquat, an occurrence that is frequently associated with deleterious outcomes. The patient was admitted following a suicide attempt involving paraquat, manifesting symptoms such as nausea, vomiting, and erythematous rashes. Despite receiving immediate and intensive treatment, including hemodialysis, antioxidant therapy, and comprehensive supportive care, the patient experienced acute lung injury on the fifth day of hospitalization, as confirmed by computed tomography (CT) scans.
Discussion: This case underscores the critical importance of early intervention and ongoing monitoring in the management of paraquat poisoning, particularly in reducing the risk of severe complications like lung injury. While the patient was ultimately discharged in stable condition, the development of lung damage underscores the need for further research into more effective therapies for paraquat toxicity.
Conclusion: This report contributes to the limited clinical knowledge surrounding paraquat poisoning, offering valuable insights for healthcare providers dealing with similar cases.

Keywords

Main Subjects

  1. Gunnell D, Eddleston M, Phillips MR, Konradsen F. The global distribution of fatal pesticide self-poisoning: systematic review. BMC public health. 2007;7:1-15.
  2. Dinis-Oliveira R, Duarte J, Sánchez-Navarro A, Remião F, Bastos M, Carvalho F. Paraquat poisonings: mechanisms of lung toxicity, clinical features, and treatment. Crit Rev Toxicol. 2008;38(1):13-71.
  3. Wang WJ, Zhang LW, Feng SY, Gao J, Li Y. Sequential organ failure assessment in predicting mortality after paraquat poisoning: A meta-analysis. PLoS One. 2018;13(11):e0207725.
  4. Roberts DM, Wilks MF, Roberts MS, Swaminathan R, Mohamed F, Dawson AH, et al. Changes in the concentrations of creatinine, cystatin C and NGAL in patients with acute paraquat self-poisoning. Toxicol Lett. 2011;202(1):69-74.
  5. Houze P, Baud F, Mouy R, Bismuth C, Bourdon R, Scherrmann J. Toxicokinetics of paraquat in humans. Hum Exp Toxicol. 1990;9(1):5-12.
  6. Gawarammana I, Dawson A. Peripheral burning sensation: a novel clinical marker of poor prognosis and higher plasma-paraquat concentrations in paraquat poisoning. Clin Toxicol. 2010;48(4):347-9.
  7. Dinis-Oliveira R, Sousa C, Remiao F, Duarte J, Navarro AS, Bastos M, et al. Full survival of paraquat-exposed rats after treatment with sodium salicylate. Free Radical Biology and Medicine. 2007;42(7):1017-28.
  8. Smith P, Heath D, Kay J. The pathogenesis and structure of paraquat‐induced pulmonary fibrosis in rats. J Pathol. 1974;114(2):57-67.
  9. Zhao Y, Tian Z, Xu T, Gao F, Guo Y, Wang G, et al. CT manifestations and prognosis of acute paraquat induced lung injury. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi, 2020;38(2):140-4.
  10. Wu W, Li Y. Lung injury caused by paraquat poisoning results in increased interleukin‑6 and decreased microRNA‑146a levels. Exp Ther Med. 2018;16(1):406-12.
  11. Suntres ZE. Role of antioxidants in paraquat toxicity. Toxicology. 2002;180(1):65-77.
  12. Park S, Lee S, Park S, Gil H, Lee E, Yang J, et al. Concurrent hemoperfusion and hemodialysis in patients with acute pesticide intoxication. Blood Purif. 2016;42(4):329-36.