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Case Reports
. 2023 Oct 14:11:350-354.
doi: 10.1016/j.toxrep.2023.10.008. eCollection 2023 Dec.

Paraquat induced acute kidney and lung injury with a dramatic response to methylprednisolone: A case report

Md Asaduzzaman  1 , Soumitra Roy  2 , Nibedita Das Pew  3 , Anindya Deb Roy  1 , Shahrin Kibria  1 , Ranjon Kumer Roy  2 , M M Jahangir Alam  2 , Shishir Ranjan Chakraborty  2
Affiliations
Case Reports

Paraquat induced acute kidney and lung injury with a dramatic response to methylprednisolone: A case report

Md Asaduzzaman et al. Toxicol Rep. .

Abstract

Background: Paraquat poisoning is one of the leading causes of fatal poisoning in many parts of the world, especially in agricultural countries. Its high toxicity even in small amounts causes rapid damage to multiple organs, especially the kidneys, lungs, and liver, mainly through free radical-mediated injury. As no specific antidote is yet available, early diagnosis and the importance of supportive therapy are critical parts of management. Some evidence suggests a survival benefit from using immunosuppressive drugs.

Case report: This case presentation concerns a 15-year-old boy from a village with a history of herbicide poisoning, later confirmed to be paraquat. Despite supportive therapy her condition continued to deteriorate with features of kidney and lung damage. The patient was then treated with methylprednisolone 500 mg daily for 5 days, along with other supportive care, and has made a remarkable recovery.

Conclusions: High efficacy as an herbicide, availability and low cost make paraquat an easy-to-encounter poison for suicidal or accidental use. Its high fatality calls for urgent and effective strategies to save lives. Methylprednisolone may play a role in its treatment.

Keywords: Herbicides; Methylprednisolone; Paraquat poisoning; Pesticides.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

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Graphical abstract
Fig. 1
Fig. 1
A large coalescent ulcer over anterior parts of Tongue (taken on day 3).
Fig. 2
Fig. 2
a: HRCT showing focal subpleural air space densities in all segments of both lung (performed on day 7). b: HRCT showing air space densities and fibrosis in right upper lung field (performed on day 7).
See this image and copyright information in PMC

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