Two Cases of Paraquat Poisoning from Kota, Rajasthan, INDIA

Abstract

Paraquat (1,1′-dimethyl-4,4′-dipyridylium) is a broad spectrum liquid herbicide associated with both accidental and intentional ingestion, leading to severe and often fatal toxicity. Despite widespread availability, reports of herbicide poisoning from India are not common. Diagnosis is often difficult in the absence of proper history, nonspecific clinical features, and lack of diagnostic tests. We report two cases of fatal paraquat poisoning from a tertiary care hospital, Kota, Rajasthan, India.

Review of a Case of Paraquat Poisoning in a Tertiary Care Rural-based ICU

“…Paraquat (1, 1′-dimethyl-4, 4′-dipyridylium) is a broad-spectrum liquid herbicide associated with both accidental and intentional ingestion leading to severe and often fatal toxicity. 1 Paraquat generates reactive oxygen species which cause cellular damage via lipid peroxidation, activation of NF-κB, mitochondrial damage, and apoptosis in many organs. Kinetics of distribution into these target tissues can be described by a two-compartment model.…”

“…ABSTRACTParaquat (1,1′-dimethyl-4, 4′-dipyridylium) is a broad-spectrum liquid herbicide associated with both accidental and intentional ingestion leading to severe and often fatal toxicity. 1 Paraquat is actively taken up against a concentration gradient into lung tissue leading to pneumonitis and lung fibrosis. Paraquat also causes renal and liver injury.…”

Paraquat poisoning-a dreadful and lethal poisoning: a case report of two cases from East Godavari, Andhra Pradesh, India

“…Paraquat poisoning may mimic acute gastroenteritis or an organophosphorous poisoning and the absence of any specific treatment guidelines or antidote further complicates the treatment. 8 Second case was a hyperacute form of paraquat poisoning, who had consumed around 100ml of paraquat and had developed features suggestive of hepatic and renal involvement within 8 hours of consumption and succumbed to shock within 2 hours of admission inspite of aggressive supportive management. 5 It's important to distinguish this form of paraquat poisoning from conditions like septic shock or anaphylaxis from history, for which specific treatment guidelines are available.…”

“…There is no specific antidote for paraquat. 8 Immediate and aggressive GI decontamination in the form of gastric lavage preceded by activated charcoal is probably the only effective treatment that may affect the outcome significantly after paraquat ingestion. 2 An open airway is maintained and ventilation assisted if needed.…”

A Case of Paraquat Poisoning Presenting With Spontaneous Pneumothorax and Pneumomediastinum

“…Around one in 12,000 cases of hospital admission presents with this [ 1 ], and it most frequently occurs in young, healthy adults without any underlying severe pulmonary disease [ 2 ]. Paraquat (1,1’-dimethyl-4,4’-dipyridylium) is a liquid herbicide associated with accidental and suicidal ingestion, leading to fatal toxicity [ 3 ]. It exerts its effect by generating reactive oxygen species (ROS), subsequently leading to the destruction of the cell membrane.…”