| Abstrakt: |
Background: To report clinical symptoms and outcome of systemic paraphenylene diamine (PPD, ingested as Super vasmol 33 hair dye) intoxication. Materials and Methods: Patients admitted with consumption of PPD were part of this observational study. Mode of consumption, amount in mililitres and time to hospitalization was recorded from history. Details of primary care after consumption and clinical symptoms till reporting to Mediciti Hospitals were recorded. Detailed laboratory evaluation including hemogram, serum electrolytes, arterial blood gas, creatinine phosphokinase (CPK), lactate dehydrogenase (LDH), renal and liver function tests were performed in all the cases. Results: Out of 10 cases six were males and four females. The mean age was 20.9 yrs. At admission, clinical symptoms were dominated by paresis, angioedema, asphyxia, oliguria and itching. The biological results were dominated by rhabdomyolysis (100%), metabolic acidosis (100%), acute renal failure (ARF) (80%), hyperphosphatemia (70%) hyperkalemia (50%) and hypocalcemia (50%). The therapies used were gastric lavage (100%), fluid infusion (100%), mechanical ventilation (80%), alkalinization (40%), corticosteroids (50%), and renal replacement therapy (80%). Six patients died. The amount of toxin, higher level of azotemia, potassium and phosphorous and lower calcium at the time of admission were significantly associated with higher mortality. Levels of CPK, LDH, AST, ALT and delay in access to tertiaty care centre were higher in those who expired, the difference was statistically not significant. Age and serum bicarbonate level did not influence mortality. Conclusions: Clinical manifestations of systemic PPD intoxication include respiratory, muscular, renal and hemodynamic syndromes. Treatment is largely supportive. Mortality rate is high and ARF affects survival adversely. [ABSTRACT FROM AUTHOR] |
