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A Case Report of Severe Paraquat Poisoning in an HIV-Positive Patient: An Unexpected Outcome and Inspiration
We described and analyzed the treatment process of an HIV-positive patient with severe paraquat (PQ) poisoning. A 34-year-old man ingested about 50 mL of a 20% solution of PQ in a suicide attempt. He was treated with gastric lavage, oral administration of adsorbent, and symptomatic treatments at the...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2015
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4554141/ https://www.ncbi.nlm.nih.gov/pubmed/25715264 http://dx.doi.org/10.1097/MD.0000000000000587 |
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author | Shang, An-Dong Lu, Yuan-Qiang |
author_facet | Shang, An-Dong Lu, Yuan-Qiang |
author_sort | Shang, An-Dong |
collection | PubMed |
description | We described and analyzed the treatment process of an HIV-positive patient with severe paraquat (PQ) poisoning. A 34-year-old man ingested about 50 mL of a 20% solution of PQ in a suicide attempt. He was treated with gastric lavage, oral administration of adsorbent, and symptomatic treatments at the local hospital, and was transferred to our emergency department. Ten hours after the exposure, the concentration of plasma PQ was 2.17 mg/L and was substantially above the survival limits of the severity index for PQ poisoning (SIPP) curve (0.30 mg/L). The equation produced by Jones et al (Jones AL, Elton R, Flanagan R. Multiple logistic regression analysis of plasma paraquat concentrations as a predictor of outcome in 375 cases of paraquat poisoning. QJM. 1999:92;573–578) predicted a 20.5% probability of survival at admission. Unfortunately, the patient was diagnosed as HIV infected, and CD4(+) lymphocyte count also confirmed that the patient was in a state of mild suppression of immunological function. Immediately, the patient received normative immunosuppressive therapy and hemoperfusion (HP). On the 15th day after poisoning, the patient recovered well and was discharged. All along, the evolution of the patient's status was in accordance with the characteristics of PQ poisoning, but the extent and duration of damage was mismatching and drastically alleviative by the previous biological indices. The particular case of treatment may be indirectly supporting the effectiveness of immunosuppressive therapy in treating patients with PQ poisoning. |
format | Online Article Text |
id | pubmed-4554141 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-45541412015-10-27 A Case Report of Severe Paraquat Poisoning in an HIV-Positive Patient: An Unexpected Outcome and Inspiration Shang, An-Dong Lu, Yuan-Qiang Medicine (Baltimore) 7200 We described and analyzed the treatment process of an HIV-positive patient with severe paraquat (PQ) poisoning. A 34-year-old man ingested about 50 mL of a 20% solution of PQ in a suicide attempt. He was treated with gastric lavage, oral administration of adsorbent, and symptomatic treatments at the local hospital, and was transferred to our emergency department. Ten hours after the exposure, the concentration of plasma PQ was 2.17 mg/L and was substantially above the survival limits of the severity index for PQ poisoning (SIPP) curve (0.30 mg/L). The equation produced by Jones et al (Jones AL, Elton R, Flanagan R. Multiple logistic regression analysis of plasma paraquat concentrations as a predictor of outcome in 375 cases of paraquat poisoning. QJM. 1999:92;573–578) predicted a 20.5% probability of survival at admission. Unfortunately, the patient was diagnosed as HIV infected, and CD4(+) lymphocyte count also confirmed that the patient was in a state of mild suppression of immunological function. Immediately, the patient received normative immunosuppressive therapy and hemoperfusion (HP). On the 15th day after poisoning, the patient recovered well and was discharged. All along, the evolution of the patient's status was in accordance with the characteristics of PQ poisoning, but the extent and duration of damage was mismatching and drastically alleviative by the previous biological indices. The particular case of treatment may be indirectly supporting the effectiveness of immunosuppressive therapy in treating patients with PQ poisoning. Wolters Kluwer Health 2015-02-27 /pmc/articles/PMC4554141/ /pubmed/25715264 http://dx.doi.org/10.1097/MD.0000000000000587 Text en Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0 |
spellingShingle | 7200 Shang, An-Dong Lu, Yuan-Qiang A Case Report of Severe Paraquat Poisoning in an HIV-Positive Patient: An Unexpected Outcome and Inspiration |
title | A Case Report of Severe Paraquat Poisoning in an HIV-Positive Patient: An Unexpected Outcome and Inspiration |
title_full | A Case Report of Severe Paraquat Poisoning in an HIV-Positive Patient: An Unexpected Outcome and Inspiration |
title_fullStr | A Case Report of Severe Paraquat Poisoning in an HIV-Positive Patient: An Unexpected Outcome and Inspiration |
title_full_unstemmed | A Case Report of Severe Paraquat Poisoning in an HIV-Positive Patient: An Unexpected Outcome and Inspiration |
title_short | A Case Report of Severe Paraquat Poisoning in an HIV-Positive Patient: An Unexpected Outcome and Inspiration |
title_sort | case report of severe paraquat poisoning in an hiv-positive patient: an unexpected outcome and inspiration |
topic | 7200 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4554141/ https://www.ncbi.nlm.nih.gov/pubmed/25715264 http://dx.doi.org/10.1097/MD.0000000000000587 |
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