Case report: Successful outcome of a young patient with rhabdomyolysis and shock caused by diquat poisoning

Abstract

The widespread use of diquat as a substitute for paraquat has led to an increase in poisoning deaths. A successful case of diquat poisoning complicated with rhabdomyolysis and shock was lacking. A 13-year-old previously healthy girl ingested 40 ml of diquat solution in a suicide attempt. The concentration of diquat in serum was 436.2 ug/L at 10 h after poisoning. The clinical course was characterized by progressive multi-organ dysfunction, particularly rhabdomyolysis and shock. The main treatments included intensive hemoperfusion combined with continuous renal replacement therapy (CRRT), drainage, and activated carbon adsorption. Meanwhile, accurate dilatation under the model of pulse indicator continuous cardiac output (PICCO) was essential for the successful treatment of shock. The serum concentration of diquat declined to 20 ug/L after 96 h of treatments. The patient was discharged from the hospital after 3 weeks of treatment without obvious symptoms. So far, this was the first successful case of diquat poisoning complicated with rhabdomyolysis and shock, which would enrich the experience of diquat poisoning treatment.

Construction of a mortality risk prediction model for patients with acute diquat poisoning based on clinically accessible data

“…Additionally, the eGFR was significantly lower in the deceased group ( P < 0.01), and there was a significantly greater number of patients with abnormal BP. A systemic inflammatory response may occur in patients with DQ [ 16 ]. Previous studies have also reported a close association between early elevation of WBC and adverse prognosis, suggesting that WBC may serve as a prognostic factor, as confirmed by the present study [ 5 , 10 , 17 ].…”

“…Furthermore, there is a strong, graded, and independent correlation between RDW and eGFR [ 21 ]. Clinically, ADP patients are characterized by multiorgan damage, primarily involving the kidneys and central nervous system [ 17 ], and some patients have complications such as anemia [ 24 ], systemic inflammatory reactions [ 16 ], and acute respiratory distress syndrome [ 5 ] in the later stages. Glomerular filtration rate is the rate at which plasma is filtered to produce ultrafiltrate.…”