Klinik und Morphologie der akuten peroralen Diquatintoxikation (Reglone)

Mechanisms of Toxicity, Clinical Features, and Management of Diquat Poisoning: A Review

“…At postmortem acute tubular necrosis was the typical lesion observed. 11,20,29,30 Bronchopneumonia has been reported at postmortem in 4 patients, 11,26,29,30 although it was diagnosed clinically in only 2 cases. 11,30 However, the radiological appearances of pulmonary infiltration and exudates observed are similar to those in the adult respiratory distress syndrome which may be the etiology of these features.…”

“…Firstly, hypovolemia following sequestration of fluid in the gut reduces renal perfusion. Secondly, diquat may have a direct toxic effect on the kidney, since in at least 6 cases, 13,14,19,26,31,32 renal failure occurred in the absence of hypovolemia. The exact mechanism of such a direct effect has not yet been elucidated.…”

“…30 Deranged liver function, as shown by a rise in liver transaminase activities, is reported commonly but is usually mild, transient, and resolves spontaneously. 15,17,19,25,26,30,31,34,35 Nephrotoxicity has been reported frequently and ranges from transient proteinuria 17,28 to acute renal failure. 11,[13][14][15][19][20][21][22][23][24][25][26][29][30][31][32]34 Renal failure has developed between 1 hour 19 and 5 days 22 postingestion and was invariably present in patients who died.…”

“…13,19,28,34 As a consequence, generalized abdominal pain, 15,25,[28][29][30]32 vomiting, 13,14,19,[24][25][26][28][29][30]35 and diarrhea 12,24-26,28-32 can occur within a few minutes of ingestion.…”

“…Corrosive damage to the oral mucosa, [11][12][13][14][15]17,22,26,28,31,34 leading to burning in the mouth and painful hemorrhagic ulceration is a common early feature of diquat ingestion. Mucosal edema of the tongue and oropharynx 13,25 may also develop and be severe enough to necessitate endotracheal intubation.…”