A case of myocarditis mimicking myocardial infarction in hair dye poisoning

Trikha, Sameer; Jatav, O. P.; Rastogi, Puneet; Kansal, Archana; Prajapati, Pradeep Kumar; Chouhan, Arvind; Singhal, Ashish; Shah, Upendra

doi:10.1016/j.jicc.2013.09.001

Cited by 2 publications

(3 citation statements)

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“…By electron oxidation, PPD is metabolized to an active radical by cytochrome P 450 peroxidase to form a reactive compound called benzoquinone diamine. This can be further oxidized to a trimer, known as Bandrowski's base, which is reported to cause anaphylaxis as well as being strongly mutagenic [4]. The toxic effect consists of a direct attack on striated muscle, but there is no indirect toxicity by metabolic or neuromuscular abnormalities.…”

Section: Discussionmentioning

confidence: 99%

“…Increased serum concentrations of troponin I (TnI) or troponin T (TnT) are more frequent than increased levels of creatinine kinase [14,15], and occur in 32-49% of patients due to myocytes damage [6]. The troponin elevation in PPD poisoning can also occur due to rhabdomyolysis, sepsis, renal injury and heart failure [4].…”

Section: Discussionmentioning

confidence: 99%

“…The most frequent causes of death are renal failure and respiratory distress. The mortality related to myocardial injury appears high [4]. In clinical practice, myocarditis diagnosis is difficult and it's often a postmortem finding.…”

Section: Discussionmentioning

confidence: 99%

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Fatal toxic myocarditis induced by Paraphenylene Diamine. A case report

Jedidi¹,

Hadj²,

Masmoudi³

et al. 2016

RJLM

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Para phenyl diamine (PPD) is an aromatic amine derivative of Aniline that is widely used as a cosmetic product, particularly in hair dye preparations. PPD acute poisoning leads to respiratory distress, rhabdomyolysis, muscle necrosis and renal failure. Cardiac complications are rarely reported in the literature. We will present a case of PPD poisoning presenting as myocarditis, associated to rhabdomyolysis with a fatal outcome. A 22-year-old man was hospitalized for ingestion of a hair dye. At admission it had a severe edema of the face and neck. Laboratory exams showed renal failure, increased serum lactate deshydrogenase, creatine phosphokinase and troponine T. Toxicological screening showed the presence of Paraphenyl Diamine in blood and stomach. The patient died in the tenth day due to a cardiogenic shock. A forensic autopsy was performed. The pericardium was spotted by multiple hemorrhagic petechiae. The myocardium and the epicardium had multiple hemorrhagic areas. Histological examinations revealed the presence of acute inflammation of the myocardium and epicardium associated with severe ulceration of the endocardium. Inflammatory infiltrate consisted mainly of neutrophils with frequent micro abscesses in the myocardium and epicardium. Death was attributed to Paraphenyl Diamine poisoning complicated with rhabdomyolysis and acute myocarditis.

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Section: Discussionmentioning

confidence: 99%