Clinical manifestations of systemic paraphenylene diamine intoxicationClinical manifestations of systemic paraphenylene diamine intoxication
Faculty of Medicine and Health Sciences
Laboratory Experimental Medicine and Pediatrics (LEMP)
Journal of nephrology. - Milano
18(2005):3, p. 308-311
University of Antwerp
Background: To report clinical symptoms and outcome of systemic paraphenylene diamine (PPD) intoxication. Methods: Our study was retrospective. It was conducted over 6 yrs (1994-2000) in die medical intensive care unit (ICU) of a university hospital and it concerned 19 patients hospitalized for systemic PPD intoxication. Results: The mean age (+/- SD) was 27.9 +/- 16.8 yrs, the sex ratio was about 0.58 and the Simplified Acute Physiology Score (SAPS II) was 30 +/- 27. At admission, clinical symptoms were dominated by cervicofacial edema (79%), chocolate brown colored urine (74%), upper airway tract edema (68.4%), oliguria (36.8%), muscular edema (26.3%) and shock (26.3%). The biological results were dominated by rhabdomyolysis (100%), metabolic acidosis (100%), acute renal failure (ARF) (47.4%) and hyperkalemia (26.3%) (biological disturbances were more pronounced in patients with ARF). The therapies used were gastric lavage (100%), fluid infusion (100%), mechanical ventilation (84.2%), alcalinization (80%), corticosteroids (84.2%), vasopressors (26.3%) and renal replacement therapy (26.3%). The intoxication evolution was marked by the death of six patients (31.6%); five of them had developed ARE The mechanical ventilation duration and the ICU stay were both more prolonged in patients who developed ARE Conclusions: Clinical manifestations of systemic PPD intoxication were associated with respiratory, muscular, renal and hemodynamic syndromes. ARF occurrence testifies to the severity of the intoxication.