Pasam Sathish Sreenivas, Majety Sameer Kumar, Nayeem Omar, Mishra Devrakshita, Chakra G Sandeep, Singh Riya, Karuchola Mallikarjuna Praneeth, Anumolu Aakash
Department of General Medicine, Rangaraya Medical College, Kakinada, India.
School of Medicine, Xiamen University, Xiamen, PR China.
Ann Med Surg (Lond). 2025 Mar 18;87(5):2537-2546. doi: 10.1097/MS9.0000000000003174. eCollection 2025 May.
Paraquat (PQ) poisoning is a grave concern in developing countries due to its wide availability. Acute paraquat poisoning can have both systemic and local manifestations, with mortality rates that can reach as high as 90%; pulmonary complications and multiple organ dysfunction syndromes being major causes. This case series is a unique retrospective observational study of 15 survivors from South India.
The case series consists of 15 cases, with a mean age of 24.6 years (excluding outliers), that were alleged to have taken varying amounts of paraquat dichloride. Patients exhibited a diverse range of symptoms affecting multiple organ systems, with particular emphasis on kidney, liver, and lung function. Treatments included a combination of hemodialysis, targeted drug therapy in the form of N-acetyl cysteine, anti-inflammatory therapy with corticosteriods and symptomatic therapy. The case descriptions also include the details of the amount of paraquat allegedly ingested, the ingestion to hospitalization time, demographics, etc, that further help in determination of prognosis.
PQ can cause a variety of clinical signs and symptoms, including gastrointestinal, renal, hepatic, and pulmonary problems. Less commonly, it can also affect the neurological and cardiac systems. Treatment is mainly focused on reducing the effective PQ concentration in blood, as no antidote has been named till date. The paper also discusses the various treatments available, drugs and procedures, and their mechanisms. Also prognostic factors like age, amount, ingestion to hospitalization time, etc.
The study underlines the need for defined treatment protocols, prognostic factors, and enforcing restrictions on availability of this deadly poison.
由于百草枯（PQ）易于获取，其中毒问题在发展中国家备受关注。急性百草枯中毒可出现全身和局部表现，死亡率可达90%；肺部并发症和多器官功能障碍综合征是主要死因。本病例系列是对15名来自印度南部幸存者的独特回顾性观察研究。
该病例系列包括15例患者，平均年龄24.6岁（不包括异常值），据称摄入了不同剂量的百草枯二氯化物。患者表现出影响多个器官系统的多种症状，尤其着重于肾脏、肝脏和肺功能。治疗方法包括血液透析、N-乙酰半胱氨酸形式的靶向药物治疗、皮质类固醇抗炎治疗和对症治疗。病例描述还包括据称摄入的百草枯量、摄入至住院时间、人口统计学等细节，这有助于进一步判断预后。
百草枯可引发多种临床体征和症状，包括胃肠道、肾脏、肝脏和肺部问题。较少见的情况下，它还可影响神经和心脏系统。治疗主要集中于降低血液中有效百草枯浓度，因为至今尚无特效解毒剂。本文还讨论了现有的各种治疗方法、药物和程序及其作用机制。还探讨了年龄、摄入量、摄入至住院时间等预后因素。
该研究强调了制定明确治疗方案、确定预后因素以及对这种致命毒药的获取实施限制的必要性。
