Department of Emergency Medicine, Fifth Affiliated Hospital of Sun Yat-Sen University, Guangdong, China.
Department of Emergency Medicine, Fifth Affiliated Hospital of Sun Yat-Sen University, Guangdong, China.
Am J Med Sci. 2022 Oct;364(4):472-480. doi: 10.1016/j.amjms.2022.04.032. Epub 2022 May 2.
We studied the case of a 36-year-old female patient who self-administered about 30 ml of diquat solution (200 g/L) during a suicide attempt. She developed nausea, vomiting, dizziness, and weakness in her limbs and was admitted to the emergency department of our hospital 4 h later. The patient developed progressive swelling and pain in both calves 12 h after admission. Based on symptoms, lower limb color Doppler ultrasound, and elevated levels of myoglobin and creatine kinase, the patient was diagnosed with rhabdomyolysis caused by diquat poisoning. The patient recovered and was discharged after treatment with hemoperfusion, continuous venovenous hemodialysis, acid suppression, liver protection, low-dose glucocorticoids, etc. Rhabdomyolysis caused by diquat poisoning has not been previously reported. We attempted to analyze the mechanism of this symptom through a literature review. We recommend the routine monitoring of creatine phosphokinase (CK) and myoglobin (MYO) in patients with diquat poisoning to avoid missed diagnosis. Further, the mechanism of this poisoning symptom was discussed through the literature review.
我们研究了一位 36 岁女性患者的病例,该患者在自杀尝试中自行服用了约 30 毫升百草枯溶液(200g/L)。她出现了恶心、呕吐、头晕和四肢无力,并在 4 小时后被送往我们医院的急诊部。入院 12 小时后,患者出现双侧小腿进行性肿胀和疼痛。根据症状、下肢彩色多普勒超声以及肌红蛋白和肌酸激酶水平升高,患者被诊断为百草枯中毒引起的横纹肌溶解症。经过血液灌流、连续静脉-静脉血液透析、抑酸、保肝、小剂量糖皮质激素等治疗后,患者康复出院。此前尚未有百草枯中毒引起的横纹肌溶解症的报道。我们试图通过文献复习分析该症状的发生机制。建议常规监测百草枯中毒患者的肌酸磷酸激酶(CK)和肌红蛋白(MYO),以避免漏诊。此外,我们还通过文献复习讨论了该中毒症状的发生机制。