Title
Clinical manifestations of systemic paraphenylene diamine intoxication Clinical manifestations of systemic paraphenylene diamine intoxication
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
Milano ,
Subject
Human medicine
Source (journal)
Journal of nephrology. - Milano
Volume/pages
18(2005) :3 , p. 308-311
ISSN
1121-8428
ISI
000230584300015
Carrier
E
Target language
English (eng)
Affiliation
University of Antwerp
Abstract
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.
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