Paraquat intoxication: a review

Authors

  • Rita Monteiro Serviço de Medicina Interna dos Hospitais da Universidade de Coimbra, EPE
  • Lurdes Correia Serviço de Medicina Interna dos Hospitais da Universidade de Coimbra, EPE
  • Adélia Simão Serviço de Medicina Interna dos Hospitais da Universidade de Coimbra, EPE
  • Armando Carvalho Serviço de Medicina Interna dos Hospitais da Universidade de Coimbra, EPE
  • Nascimento Costa Serviço de Medicina Interna dos Hospitais da Universidade de Coimbra, EPE

Keywords:

Paraquat, poisoning, review, urine Paraquat test

Abstract

Paraquat is a very toxic herbicide still available in Portugal and
a cause of many deadly cases. The diagnosis is emergent and
sometimes complex. The prognosis is poor, mainly in cases of
high doses intoxication as there is no proven effective therapy.
The authors review the pharmacokinetics, mechanism of action, clinical manifestations, available therapies and prognostic
factors. They highlight the low sensitivity of urine Paraquat test
in diagnosis and the importance of blood Paraquat test in the
prognosis. Finally, a call for the development of research leading
to new therapies is made.

Downloads

Download data is not yet available.

References

Honoré P, Hantson P, Fauville JP, Peeters A, Manieu P. Paraquat poisoning. «State of the art». Acta Clin Belg 1994;49(5):220-228.

Dinis-Oliveira RJ, de Pinho PG, Santos L, Teixeira H, Magalhães T, Santos A, de Lourdes Bastos M, Remião F, Duarte JA, Carvalho F. Postmortem analyses unveil the poor efficacy of decontamination, anti-inflammatory and immunosuppressive therapies in paraquat human intoxications. PLoS ONE 2009;4(9):e7149.

Serra A, Domingos F, Prata MM. [Paraquat intoxication]. Acta Med Port 2003;16(1):25-32.

Castro R, Prata C, Oliveira L, Carvalho MJ, Santos J, Carvalho F, Morgado T. [Paraquat intoxication and hemocarboperfusion]. Acta Med Port

;18(6):423-431.

Dinis-Oliveira RJ, Duarte JA, Sánchez-Navarro A, Remião F, Bastos ML, Carvalho F. Paraquat poisonings: mechanisms of lung toxicity, clinical features, and treatment. Crit Rev Toxicol 2008;38(1):13-71.

Ponce P, Lobos AV, Bordalo J, Moreira J. [Treatment of paraquat poisoning. Plasmapheresis versus hemodialysis]. Acta Med Port 1986;7(5-6):193-196.

Pinheiro I. Intoxicação por paraquat - revisão bibliográfica. Rev Port Med Int 2002;9(4):229-232.

Tsatsakis AM, Perakis K, Koumantakis E. Experience with acute paraquat poisoning in Crete. Vet Hum Toxicol 1996 ;38(2):113-117.

Van Vleet TR, Schnellmann RG. Toxic nephropathy: environmental chemicals. Semin Nephrol 2003;23(5):500-508.

Schmitt GC, Paniz C, Grotto D, Valentini J, Schott KL, Pomblum VJ, Garcia SC. Aspectos gerais e diagnóstico clinicolaboratorial da intoxicação

por paraquat. J Bras Patol Med Lab 2006;42(4):235-243.

Nagami H, Nishigaki Y, Matsushima S, Yajima N. Paraquat Poisoning in Japan: A Hospital-based Survey. J Rural Med 2007;2(2):85-92.

Hong SY, Yang DH, Hwang KY. Associations between laboratory parameters and outcome of paraquat poisoning.Toxicol Lett 2000;118(1-2):53-59.

Monteiro R, Correia L, Simão A, Carvalho A, Nascimento C. Paraquatúria negativa não exclui intoxicação por paraquat. Rev Port Med Int (Ed. especial); Maio 2010;17;S102.

Scherrmann JM, Houze P, Bismuth C, Bourdon R. Prognostic value of plasma and urine paraquat concentration. Hum Toxicol 1987;6(1):91-93.

Huang NC, Lin SL, Hung SY, Chung HM. Severity assessment in acute paraquat poisoning by analysis of APACHE II score. J Formos Med Assoc 2003;102(11):782-787.

Huang NC, Hung SY, Lin SL, Wann SR, Hsu CW, Ger LP, Hung SY, Chung HM, Yeh JH. Further evidence of the usefulness of Acute Physiology and Chronic Health Evaluation II scoring system in acute paraquat poisoning. Clin Toxicol (Phila) 2006;44(2):99-102.

Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med 1985:13(10):818-829.

López Lago AM, Rivero Velasco C, Galban Rodríguez C, Mariño Rozados A, Piñeiro Sande N, Ferrer Vizoso E. [Paraquat poisoning and hemoperfusion with activated charcoal]. An Med Interna 2002;19(6):310-312.

Suzuki K, Takasu N, Okabe T, Ishimatsu S, Ueda A, Tanaka S, Fukuda A, Arita S, Kohama A. Effect of aggressive haemoperfusion on the clinical course of patients with paraquat poisoning. Hum ExpToxicol 1993;12(4):323-327.

Okonek S, Hofmann A, Henningsen B. Efficacy of gut lavage, hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication. Arch Toxicol 1976;36(1):43-51.

Redetzki HM, Wood CD, Grafton WD. Vitamin E and paraquat poisoning. Vet Hum Toxicol 1980;22(6):395-397.

Lin JL, Wei MC, Liu YC. Pulse therapy with cyclophosphamide and methylprednisolone in patients with moderate to severe paraquat poisoning: a preliminary report. Thorax 1996;51(7):661-663.

Lin JL, Lin-Tan DT, Chen KH, Huang WH. Repeated pulse of methylprednisolone and cyclophosphamide with continuous dexamethasone therapy for patients with severe paraquat poisoning. Crit Care Med 2006;34(2):368-373.

Williams GH, Dluhy RG. Disorders of the adrenal cortex. Harrison`s Principles of Internal Medicine 17th edition, McGraw-Hill 2008; 2247-2269

.25. Nagao M, Takatori T, Wu B, Terazawa K, Gotouda H, Akabane H. Immunotherapy for the treatment of acute paraquat poisoning. Hum Toxicol 1989;8(2):121-123.

Addo E, Poon-King T. Leucocyte suppression in treatment of 72 patients with paraquat poisoning. Lancet 1986;1(8490):1117-1120.

Perriëns JH, Benimadho S, Kiauw IL, Wisse J, Chee H. High-dose cyclophosphamide and dexamethasone in paraquat poisoning: a prospective study. Hum ExpToxicol 1992;11(2):129-134.

Botella de Maglia J, Belenguer Tarín JE. [Paraquat poisoning.A study of 29 cases and evaluation of the effectiveness of the “Caribbean scheme”]. Med Clin (Barc) 2000;115(14):530-533.

Santos JM, Santos A, Simão A, Almiro E, Severo F, Porto A. Intoxicação pelo Paraquat - Casuística. Rev Port Med Int 1996;3(2):74-80.

Wassermann K, Franzen D, Baer F, Heitz W, Mecking H, Eidt S, Käferstein H, Baldamus CA, Curtius JM, Höpp HW. Failure of radiotherapy to resolve fatal lung damage due to paraquat poisoning. Chest 1991;100(4):1164-1165.

Talbot AR, Barnes MR. Radiotherapy for the treatment of pulmonary complications of paraquat poisoning. Hum Toxicol 1988;7(4):325-332.

Talbot AR, Barnes MR, Ting RS. Early radiotherapy in the treatment of paraquat poisoning. Br J Radiol 1988;61(725):405-408.

Savy FP, Duval G, Her B, Canu P, Fintelz P. [Failure of chemotherapy and radiotherapy in pulmonary fibrosis caused by paraquat]. Ann Fr Anesth Reanim 1988;7(2):159-161.

Shirahama M, Sakemi T, Osato S, Sanai T, Rikitake O, Wada S. Recovery after radiotherapy from severe interstitial pneumonia due to paraquat poisoning. Jpn J Med 1987;26(3):385-387.

Webb DB, Williams MV, Davies BH, James KW. Resolution after radiotherapy of severe pulmonary damage due to paraquat poisoning. Br Med J (Clin Res Ed) 1984;288(6426):1259-1260.

Licker M, Schweizer A, Hohn L, Morel DR, Spiliopoulos A. Single lung transplantation for adult respiratory distress syndrome after paraquat poisoning. Thorax 1998;53(7):620-621.

Sequential bilateral lung transplantation for paraquat poisoning. A case report.The Toronto Lung Transplant group. J Thorac Cardiovasc Surg 1985 May;89(5):734-742.

Caldas L, Braga A, Martins I, Toledo-Piza E, Guerra L, Rodrigues R, Rosaura L. Treatment of the experimental acute poisoning by paraquat with thalidomide, montelukast and acethylsalicilic acid. Rev bras toxicol 2004;17(1):11-25

Additional Files

Published

2011-09-30

How to Cite

1.
Monteiro R, Correia L, Simão A, Carvalho A, Costa N. Paraquat intoxication: a review. RPMI [Internet]. 2011 Sep. 30 [cited 2024 May 18];18(3):173-80. Available from: https://revista.spmi.pt/index.php/rpmi/article/view/1332

Issue

Section

Review Articles

Most read articles by the same author(s)

<< < 1 2