- Produce free radicals and cytokines, that destroy all most every organ system
Clinical features
- Oral burn, Paraquat tongue (pathognomonic), dysphagia, vomiting, diarrhea
- Respiratory: Pneumonitis, pulmonary fibrosis
- Renal: AKI, Renal failure, Multi-organ failure
- Hepatic: hepatitis
- Brain not involved: painful situation for the patient (can not cross BBB)
Investigation
- CBC, RFT, ABG analysis, LFT
- CXR, HRCT, serum lactate
- Confirmation- urinary dithionite test
- Prognosis- plasma paraquat concentration
Information regarding management:
- Time of ingestion
- Amount of ingestion
- H/O vomiting immediately after ingestion
Management
- No specific antidote
- Gastric lavage- contraindicated
- Decontamination:
- Activated charcoal (within 2-4 hours)
- skin washing by shop water over 15 minutes
- Avoid Oxygen, unless there is hypoxia (SpO2 < 90 %)
- oxygen with help to produce more free radicals
- Immunosuppression with glucocorticoids and cyclophosphamide
Prognosis
- Irrespective of treatment, death is common
- substantial poisoning→ within 24 hours
- lower dose→ after 1-2 weeks
Mortality around 100% (fatal disease)
- Paraquat poisoning
- Rabies, Tetanus
- TA-GVHD