Department of Poisoning and Occupational Diseases, Emergency Medicine, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, China.
Shandong University of Traditional Chinese Medicine, Jinan, China.
Front Public Health. 2022 Oct 24;10:991587. doi: 10.3389/fpubh.2022.991587. eCollection 2022.
Diquat is a herbicide that can have deleterious effects on the kidneys, liver, heart, lungs, and central nervous system on ingestion. Diquat poisoning-associated rhabdomyolysis has rarely been reported. We describe two cases of diquat poisoning with acute renal failure, myocardial damage, and rhabdomyolysis. Case 1: A 17-year-old man experienced anuria after ingesting ~200 mL of diquat 16 h prior. On admission, his creatinine (400 μmol/L), urea (11.7 mmol/L), creatine kinase (2,534 IU/L), and myohemoglobin (4,425 ng/mL) concentrations were elevated. Case 2: An 18-year-old woman who ingested ~200 mL of diquat 5.5 h prior to admission had normal creatinine, urea, and creatine kinase concentrations. Eleven hours after ingestion, she developed anuria with elevated creatinine (169 μmol/L) concentration; her creatine kinase (13,617 IU/L) and myohemoglobin (>3,811 ng/mL) concentrations were remarkably elevated 24 h after ingestion. Both patients also had elevated aminotransferase and myocardial enzyme concentrations. After undergoing hemoperfusion and hemofiltration, blood diquat concentrations in cases 1 and 2 on admission (16/6 h after ingestion), after hemoperfusion (20/11 h after ingestion), and after 8 h of hemofiltration/8 h of hemofiltration and 2 h of hemoperfusion (29/21 h after ingestion) were 4.9/9.1, 3.4/5.4, and 1.5/1.2 μg/mL, respectively. Severe diquat poisoning can cause acute kidney failure and rhabdomyolysis. Rhabdomyolysis may induce myocardial injury, aggravating kidney damage, and also increase transaminase concentration. Hemoperfusion and hemofiltration could be effective treatments for eliminating diquat in the blood.
敌草快是一种除草剂，摄入后会对肾脏、肝脏、心脏、肺和中枢神经系统造成有害影响。敌草快中毒相关的横纹肌溶解症很少见。我们描述了两例敌草快中毒导致急性肾衰竭、心肌损伤和横纹肌溶解症的病例。
病例 1：一名 17 岁男性在摄入约 200 毫升敌草快 16 小时后出现无尿。入院时，他的肌酐（400 μmol/L）、尿素（11.7 mmol/L）、肌酸激酶（2534 IU/L）和肌红蛋白（4425ng/ml）浓度升高。
病例 2：一名 18 岁女性在入院前 5.5 小时摄入约 200 毫升敌草快，肌酐、尿素和肌酸激酶浓度正常。摄入后 11 小时，她出现无尿，肌酐（169 μmol/L）浓度升高；摄入后 24 小时，她的肌酸激酶（13617IU/L）和肌红蛋白（>3811ng/ml）浓度显著升高。两名患者的转氨酶和心肌酶浓度也升高。
在进行血液灌流和血液滤过治疗后，病例 1 和 2 入院时（摄入后 16/6 小时和 20/11 小时）、血液灌流后（摄入后 29/21 小时）以及血液滤过 8 小时/血液滤过和血液灌流 2 小时后（摄入后 29/21 小时）的血敌草快浓度分别为 4.9/9.1、3.4/5.4 和 1.5/1.2μg/ml。严重的敌草快中毒可导致急性肾衰竭和横纹肌溶解症。横纹肌溶解症可能引起心肌损伤，加重肾脏损害，同时增加转氨酶浓度。血液灌流和血液滤过可能是清除血液中敌草快的有效治疗方法。
