Clinical manifestations of systemic paraphenylene diamine intoxication.

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 the 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 ARF. The mechanical ventilation duration and the ICU stay were both more prolonged in patients who developed ARF.

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.

• Authors: Hatem Kallel, Hedi Chelly, Hassen Dammak, Mabrouk Bahloul, Hichem Ksibi, Chokri Ben Hamida, Adel Chaari, Noureddine Rekik, Marc E De Broe, Mounir Bouaziz
• Journal: Journal of nephrology (J Nephrol) 2005 May-Jun Vol. 18 Issue 3 Pg. 308-11 ISSN: 1121-8428 [Print] Italy
• PMID: 16013020 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Coloring Agents
• Glucocorticoids
• Phenylenediamines
• Urea
• Creatinine
• Creatine Kinase
• 4-phenylenediamine

Topics

• Acute Kidney Injury (blood, chemically induced, therapy)
• Adult
• Coloring Agents (poisoning)
• Creatine Kinase (blood)
• Creatinine (blood)
• Female
• Follow-Up Studies
• Gastric Lavage
• Glucocorticoids (therapeutic use)
• Humans
• Intensive Care Units
• Kidney Transplantation
• Male
• Phenylenediamines (poisoning)
• Respiration, Artificial
• Retrospective Studies
• Rhabdomyolysis (blood, chemically induced, therapy)
• Severity of Illness Index
• Treatment Outcome
• Urea (blood)