Umair Syed Farrukh, Amin Imrana, Urrehman Ata
Dr. Syed Farrukh Umair, FCPS. Department of Medicine, Patel Hospital, Karachi, Pakistan.
Dr. Imrana Amin, FCPS. Department of Medicine, Patel Hospital, Karachi, Pakistan.
Pak J Med Sci. 2018 Jan-Feb;34(1):230-232. doi: 10.12669/pjms.341.14123.
The use of hair dye has been emerging worldwide however usage of Paraphenylenediamine (PPD) in making hair dye is generally restricted to underdeveloped and developing countries. In particular, prevalence of accidental and suicidal ingestion is more in low socioeconomic areas. The spectra of hair dye toxicity is wide, however, it presents more commonly with severe angioedema of face and neck leading to respiratory failure, rhabdomyolysis complicating into acute kidney injury, myocarditis and acute liver injury. Here we present a unique case of PPD poisoning in a young female presented with laryngeal edema and marked rhabdomyolysis. Preemptive shifting to Critical care unit and elective endotracheal intubation for air way patency obviated the need of tracheostomy and precluded its related complications. Moreover, aggressive intravenous hydration prevented from renal failure despite markedly raised Creatine phospho kinase (CPK) levels.
染发剂的使用在全球范围内不断增加,然而,对苯二胺(PPD)在染发剂制造中的使用一般仅限于不发达国家和发展中国家。特别是在社会经济地位较低的地区,意外和自杀性摄入的发生率更高。染发剂毒性的范围很广,然而,它更常见的表现是面部和颈部严重血管性水肿,导致呼吸衰竭、横纹肌溶解并发急性肾损伤、心肌炎和急性肝损伤。在此,我们报告一例年轻女性对苯二胺中毒的独特病例,该患者表现为喉头水肿和明显的横纹肌溶解。预先转移到重症监护病房并进行选择性气管插管以保持气道通畅,避免了气管切开术的需要并预防了其相关并发症。此外,尽管肌酸磷酸激酶(CPK)水平显著升高,但积极的静脉补液预防了肾衰竭。