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A case report of acute severe paraquat poisoning and long-term follow-up.

Yu G, Kan B, Jian X, Wang J, Sun J, Song C - Exp Ther Med (2014)

Bottom Line: The patient was successfully treated and recovered after 40 days.Subsequent to a 8-month follow-up, the patient was able to look after herself in her daily life.To the best of our knowledge, successful treatment following severe PQ poisoning is rare.

View Article: PubMed Central - PubMed

Affiliation: Department of Poisoning and Occupational Diseases, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China.

ABSTRACT
In the present study, the successful management of severe paraquat (PQ) poisoning with multiple organ dysfunction syndrome is described. A 42-year-old female ingested >100 ml PQ (20% weight/volume) in an attempted suicide. After 22 h the patient was admitted to hospital with serious liver, kidney and lung damage. Comprehensive therapy that maximized poison elimination was administered, along with appropriate glucocorticoids and medication for anticoagulation and protection of the liver and kidney. The patient was successfully treated and recovered after 40 days. However, pulmonary damage was aggravated when the glucocorticoid treatment was stopped after 2 months; the lungs recovered again following systematic therapy. Subsequent to a 8-month follow-up, the patient was able to look after herself in her daily life. To the best of our knowledge, successful treatment following severe PQ poisoning is rare.

No MeSH data available.


Related in: MedlinePlus

Lung CT scans at different time-points following ingestion of paraquat. (A) At 44 days following ingestion, the lung fibrosis had decreased. (B) At 75 days post-ingestion the lung damage was aggravated. Larger lesions with air and fluid bronchograms, surrounded by a wide range of patchy lesions were observed. (C) A follow up CT scan after 148 days showed that the lung damage had decreased markedly once the treatment was resumed. (D) A CT of the lung 236 days following paraquat exposure revealed localized fibrosis was improved. CT, computed tomography.
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f2-etm-08-01-0233: Lung CT scans at different time-points following ingestion of paraquat. (A) At 44 days following ingestion, the lung fibrosis had decreased. (B) At 75 days post-ingestion the lung damage was aggravated. Larger lesions with air and fluid bronchograms, surrounded by a wide range of patchy lesions were observed. (C) A follow up CT scan after 148 days showed that the lung damage had decreased markedly once the treatment was resumed. (D) A CT of the lung 236 days following paraquat exposure revealed localized fibrosis was improved. CT, computed tomography.

Mentions: Following multi-target comprehensive therapy, the dynamic changes in the lung CT scans are shown in Fig. 1 and 2, and the main laboratory test results are shown in Table I. The liver and kidney functions were seriously damaged 2 days following ingestion and the most serious damage was observed 6 days subsequent to PQ poisoning. However, the liver and kidney functions gradually recovered 2 weeks later (Table I). The initial CT scan showed that there was a certain degree of lung injury that occurred after 2 days (Fig. 1A) and gradually accelerated over the following 3 days (Fig. 1B). Serious lung injury occurred 15 days later (Fig. 1C); however, it improved gradually during the 6 weeks of treatment (Fig. 1D and Fig. 2A). Treatment was ceased gradually; however, after 2 months the lung injury re-occurred (Fig. 2B) accompanied by marked liver dysfunction. Treatment was then resumed and lung function improved again (Fig. 2C), and the liver function gradually returned to normal. Eight months following ingestion, the patient’s lung function was markedly improved (Fig. 2D). The pulmonary function test indicated moderate restrictive ventilation dysfunction and a mild decline of diffuse lung function with the forced vital capacity, maximum vital capacity, maximum ventilatory volume and carbon monoxide diffusion capacity accounting for 53.2, 52.1, 67.3 and 54.1% of the expected values, respectively. The patient continues to be followed up.


A case report of acute severe paraquat poisoning and long-term follow-up.

Yu G, Kan B, Jian X, Wang J, Sun J, Song C - Exp Ther Med (2014)

Lung CT scans at different time-points following ingestion of paraquat. (A) At 44 days following ingestion, the lung fibrosis had decreased. (B) At 75 days post-ingestion the lung damage was aggravated. Larger lesions with air and fluid bronchograms, surrounded by a wide range of patchy lesions were observed. (C) A follow up CT scan after 148 days showed that the lung damage had decreased markedly once the treatment was resumed. (D) A CT of the lung 236 days following paraquat exposure revealed localized fibrosis was improved. CT, computed tomography.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4061211&req=5

f2-etm-08-01-0233: Lung CT scans at different time-points following ingestion of paraquat. (A) At 44 days following ingestion, the lung fibrosis had decreased. (B) At 75 days post-ingestion the lung damage was aggravated. Larger lesions with air and fluid bronchograms, surrounded by a wide range of patchy lesions were observed. (C) A follow up CT scan after 148 days showed that the lung damage had decreased markedly once the treatment was resumed. (D) A CT of the lung 236 days following paraquat exposure revealed localized fibrosis was improved. CT, computed tomography.
Mentions: Following multi-target comprehensive therapy, the dynamic changes in the lung CT scans are shown in Fig. 1 and 2, and the main laboratory test results are shown in Table I. The liver and kidney functions were seriously damaged 2 days following ingestion and the most serious damage was observed 6 days subsequent to PQ poisoning. However, the liver and kidney functions gradually recovered 2 weeks later (Table I). The initial CT scan showed that there was a certain degree of lung injury that occurred after 2 days (Fig. 1A) and gradually accelerated over the following 3 days (Fig. 1B). Serious lung injury occurred 15 days later (Fig. 1C); however, it improved gradually during the 6 weeks of treatment (Fig. 1D and Fig. 2A). Treatment was ceased gradually; however, after 2 months the lung injury re-occurred (Fig. 2B) accompanied by marked liver dysfunction. Treatment was then resumed and lung function improved again (Fig. 2C), and the liver function gradually returned to normal. Eight months following ingestion, the patient’s lung function was markedly improved (Fig. 2D). The pulmonary function test indicated moderate restrictive ventilation dysfunction and a mild decline of diffuse lung function with the forced vital capacity, maximum vital capacity, maximum ventilatory volume and carbon monoxide diffusion capacity accounting for 53.2, 52.1, 67.3 and 54.1% of the expected values, respectively. The patient continues to be followed up.

Bottom Line: The patient was successfully treated and recovered after 40 days.Subsequent to a 8-month follow-up, the patient was able to look after herself in her daily life.To the best of our knowledge, successful treatment following severe PQ poisoning is rare.

View Article: PubMed Central - PubMed

Affiliation: Department of Poisoning and Occupational Diseases, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China.

ABSTRACT
In the present study, the successful management of severe paraquat (PQ) poisoning with multiple organ dysfunction syndrome is described. A 42-year-old female ingested >100 ml PQ (20% weight/volume) in an attempted suicide. After 22 h the patient was admitted to hospital with serious liver, kidney and lung damage. Comprehensive therapy that maximized poison elimination was administered, along with appropriate glucocorticoids and medication for anticoagulation and protection of the liver and kidney. The patient was successfully treated and recovered after 40 days. However, pulmonary damage was aggravated when the glucocorticoid treatment was stopped after 2 months; the lungs recovered again following systematic therapy. Subsequent to a 8-month follow-up, the patient was able to look after herself in her daily life. To the best of our knowledge, successful treatment following severe PQ poisoning is rare.

No MeSH data available.


Related in: MedlinePlus