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百草枯中毒导致急性肾损伤:一例成年患者的病例报告

Paraquat Toxicity Leading to Acute Kidney Injury: A Case Report in an Adult Patient.

作者信息

Shah Newton Ashish, Yadav Manish, Sah Rupesh, Rajbhandari Bibek

机构信息

Maharajgunj Medical Campus Institute of Medicine, Maharajgunj, Kathmandu, Nepal.

Universal College of Medical Sciences, Ranigaon, Bhairahawa, Nepal.

出版信息

JNMA J Nepal Med Assoc. 2024 Apr 30;62(273):343-346. doi: 10.31729/jnma.8560.

Abstract

Paraquat poisoning poses a significant and emerging public health challenge in developing countries. The distribution and usage of Paraquat, a potent herbicide, remain unrestricted in many regions despite its high fatality rate and absence of a specific antidote. Paraquat mostly involves lungs but can also involve the kidneys and liver. Diagnostic challenges and a lack of available samples at presentation contribute to underreporting and limited awareness among healthcare providers, making paraquat poisoning a neglected toxicological emergency. Herein, we present a case of a 40-year-old male who presented to the emergency department on the fourth day after ingesting paraquat in a suicidal attempt. Upon presentation, he had erosion on the tongue and posterior pharyngeal wall, along with deranged renal function tests and elevated serum creatinine levels. The patient developed acute kidney injury, with serum creatinine levels rapidly rising from normal to 3.85 mg/dl, accompanied by a decrease in daily urine output. He was managed conservatively, and his hospital stay was uneventful.

摘要

百草枯中毒在发展中国家构成了重大且新出现的公共卫生挑战。百草枯是一种强效除草剂,尽管其致死率高且缺乏特效解毒剂,但在许多地区其销售和使用仍未受到限制。百草枯中毒主要累及肺部,但也可累及肾脏和肝脏。诊断方面的挑战以及就诊时缺乏可用样本导致报告不足,医疗服务提供者的认识有限,使得百草枯中毒成为一种被忽视的毒理学急症。在此,我们报告一例40岁男性病例,该患者在自杀性吞服百草枯后第4天就诊于急诊科。就诊时,他的舌头和咽后壁有糜烂,同时肾功能检查紊乱,血清肌酐水平升高。该患者发生了急性肾损伤,血清肌酐水平从正常迅速升至3.85mg/dl,同时每日尿量减少。他接受了保守治疗,住院期间病情平稳。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bfb/11261553/4cb1ea566458/JNMA-62-273-343-g1.jpg

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