Cartagena Sebastián, Díaz Israel, Gutiérrez Constanza, Dreyse Jorge, Florenzano Matías, Palavecino Marcela, Regueira Tomás
Facultad de Medicina, Universidad Finis Terrae, Santiago, Chile.
Centro de Pacientes Críticos, Clínica Las Condes, Santiago, Chile.
Rev Med Chil. 2018 Jul;146(7):938-941. doi: 10.4067/s0034-98872018000700938.
Paraquat, a non-selective bipyridyl pesticide, is one of the leading causes of death from intoxication in many parts of Asia and America. It is the second most sold herbicide worldwide, being widely used in Chile. Its ingestion generates toxicity due to the release of superoxide radicals, mainly affecting kidneys, lungs and liver. There is no antidote available. We report a 31 years old male who ingested Paraquat for suicidal purposes. He developed an acute renal and hepatic failure and a rapidly progressive severe respiratory failure with images compatible with acute pulmonary fibrosis. No response to immunosuppressive treatment was observed. He died eight days after admission. The use of cyclophosphamide associated with glucocorticoids could lower risk of death the in these patients, although the pathophysiology of respiratory failure is still under study.
百草枯是一种非选择性联吡啶类农药,是亚洲和美洲许多地区中毒致死的主要原因之一。它是全球第二大畅销除草剂,在智利广泛使用。摄入百草枯会因超氧自由基的释放而产生毒性,主要影响肾脏、肺和肝脏。目前尚无解毒剂。我们报告一名31岁男性,因自杀目的摄入百草枯。他出现了急性肾和肝功能衰竭以及迅速进展的严重呼吸衰竭,影像学表现符合急性肺纤维化。免疫抑制治疗未见反应。他在入院八天后死亡。环磷酰胺与糖皮质激素联合使用可能会降低这些患者的死亡风险,尽管呼吸衰竭的病理生理学仍在研究中。