Jain P K, Agarwal N, Kumar P, Sengar N S, Agarwal Nutan, Akhtar Asif
Department of Medicine, M.L.B. Medical College, Jhansi - 284128, U.P.
J Assoc Physicians India. 2011 Jul;59:415-9.
Hair dye (Paraphenylene di-amine, PPD) poisoning has high morbidity and mortality and its incidence has increased dramatically in the past 4 years. A prospective study was planned to assess the clinical profile and outcome with different treatment approaches.
The material comprised of 1020 cases admitted in Medicine Department of MLB Medical College, Jhansi, U.P. from July 2004 to March 2009. Out of 1020 cases 697 cases were of stone hair dye poisoning and 323 cases were of other branded hair dyes (powdered form containing less amount of Paraphenylene diamine). Diagnosis was made solely on the basis of the history given by cases/attendant and symptoms of neck swelling, black coloured urine and muscular pain. The cases were thoroughly studied for different complications (renal, hepatic and cardiac etc) and were treated accordingly.
Out of 1020 cases studied, majority were females in the age group of 15-45 yrs (n=734) while the rest were males. A total of 244 (23.92%) cases expired during treatment. Neck swelling, respiratory distress and whole body muscular pain were most common symptoms at presentation, oliguria, chest pain, palpitation, presyncope/syncope, pain in abdomen, nausea with vomiting and dysphagia were other common symptoms.
Paraphenylene diamine is highly toxic. Cases who consumed up to 10 gm of PPD usually survived if they presented to hospital within 4 hour of dye ingestion. Severe edema of face, neck and floor of mouth, renal failure and myocarditis were poor prognostic factors. No deaths occurred in cases of Branded Hair dye ingestion.
染发剂(对苯二胺,PPD)中毒的发病率和死亡率很高,在过去4年中其发病率急剧上升。计划进行一项前瞻性研究,以评估不同治疗方法的临床特征和结果。
材料包括2004年7月至2009年3月在印度北方邦占西市MLB医学院内科收治的1020例病例。在1020例病例中,697例为石牌染发剂中毒,323例为其他品牌染发剂(粉末状,对苯二胺含量较少)。诊断仅基于病例/陪护人员提供的病史以及颈部肿胀、尿液变黑和肌肉疼痛的症状。对病例进行了关于不同并发症(肾脏、肝脏和心脏等)的全面研究,并相应地进行了治疗。
在研究的1020例病例中,大多数为15 - 45岁的女性(n = 734),其余为男性。共有244例(23.92%)在治疗期间死亡。颈部肿胀、呼吸窘迫和全身肌肉疼痛是最常见的就诊症状,少尿、胸痛、心悸、先兆晕厥/晕厥、腹痛、恶心伴呕吐和吞咽困难是其他常见症状。
对苯二胺毒性很高。摄入多达10克PPD的病例如果在摄入染发剂后4小时内入院通常能够存活。面部、颈部和口腔底部的严重水肿、肾衰竭和心肌炎是不良预后因素。摄入品牌染发剂的病例未发生死亡。