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Case series: Diquat poisoning with acute kidney failure, myocardial damage, and rhabdomyolysis

Diquat is a herbicide that can have deleterious effects on the kidneys, liver, heart, lungs, and central nervous system on ingestion. Diquat poisoning-associated rhabdomyolysis has rarely been reported. We describe two cases of diquat poisoning with acute renal failure, myocardial damage, and rhabdo...

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Autores principales: Yu, Guangcai, Wang, Jieru, Jian, Tianzi, Shi, Longke, Zhao, Liwen, Li, Yaqian, Gao, Yikai, Kan, Baotian, Jian, Xiangdong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9638031/
https://www.ncbi.nlm.nih.gov/pubmed/36353285
http://dx.doi.org/10.3389/fpubh.2022.991587
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author Yu, Guangcai
Wang, Jieru
Jian, Tianzi
Shi, Longke
Zhao, Liwen
Li, Yaqian
Gao, Yikai
Kan, Baotian
Jian, Xiangdong
author_facet Yu, Guangcai
Wang, Jieru
Jian, Tianzi
Shi, Longke
Zhao, Liwen
Li, Yaqian
Gao, Yikai
Kan, Baotian
Jian, Xiangdong
author_sort Yu, Guangcai
collection PubMed
description Diquat is a herbicide that can have deleterious effects on the kidneys, liver, heart, lungs, and central nervous system on ingestion. Diquat poisoning-associated rhabdomyolysis has rarely been reported. We describe two cases of diquat poisoning with acute renal failure, myocardial damage, and rhabdomyolysis. Case 1: A 17-year-old man experienced anuria after ingesting ~200 mL of diquat 16 h prior. On admission, his creatinine (400 μmol/L), urea (11.7 mmol/L), creatine kinase (2,534 IU/L), and myohemoglobin (4,425 ng/mL) concentrations were elevated. Case 2: An 18-year-old woman who ingested ~200 mL of diquat 5.5 h prior to admission had normal creatinine, urea, and creatine kinase concentrations. Eleven hours after ingestion, she developed anuria with elevated creatinine (169 μmol/L) concentration; her creatine kinase (13,617 IU/L) and myohemoglobin (>3,811 ng/mL) concentrations were remarkably elevated 24 h after ingestion. Both patients also had elevated aminotransferase and myocardial enzyme concentrations. After undergoing hemoperfusion and hemofiltration, blood diquat concentrations in cases 1 and 2 on admission (16/6 h after ingestion), after hemoperfusion (20/11 h after ingestion), and after 8 h of hemofiltration/8 h of hemofiltration and 2 h of hemoperfusion (29/21 h after ingestion) were 4.9/9.1, 3.4/5.4, and 1.5/1.2 μg/mL, respectively. Severe diquat poisoning can cause acute kidney failure and rhabdomyolysis. Rhabdomyolysis may induce myocardial injury, aggravating kidney damage, and also increase transaminase concentration. Hemoperfusion and hemofiltration could be effective treatments for eliminating diquat in the blood.
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spelling pubmed-96380312022-11-08 Case series: Diquat poisoning with acute kidney failure, myocardial damage, and rhabdomyolysis Yu, Guangcai Wang, Jieru Jian, Tianzi Shi, Longke Zhao, Liwen Li, Yaqian Gao, Yikai Kan, Baotian Jian, Xiangdong Front Public Health Public Health Diquat is a herbicide that can have deleterious effects on the kidneys, liver, heart, lungs, and central nervous system on ingestion. Diquat poisoning-associated rhabdomyolysis has rarely been reported. We describe two cases of diquat poisoning with acute renal failure, myocardial damage, and rhabdomyolysis. Case 1: A 17-year-old man experienced anuria after ingesting ~200 mL of diquat 16 h prior. On admission, his creatinine (400 μmol/L), urea (11.7 mmol/L), creatine kinase (2,534 IU/L), and myohemoglobin (4,425 ng/mL) concentrations were elevated. Case 2: An 18-year-old woman who ingested ~200 mL of diquat 5.5 h prior to admission had normal creatinine, urea, and creatine kinase concentrations. Eleven hours after ingestion, she developed anuria with elevated creatinine (169 μmol/L) concentration; her creatine kinase (13,617 IU/L) and myohemoglobin (>3,811 ng/mL) concentrations were remarkably elevated 24 h after ingestion. Both patients also had elevated aminotransferase and myocardial enzyme concentrations. After undergoing hemoperfusion and hemofiltration, blood diquat concentrations in cases 1 and 2 on admission (16/6 h after ingestion), after hemoperfusion (20/11 h after ingestion), and after 8 h of hemofiltration/8 h of hemofiltration and 2 h of hemoperfusion (29/21 h after ingestion) were 4.9/9.1, 3.4/5.4, and 1.5/1.2 μg/mL, respectively. Severe diquat poisoning can cause acute kidney failure and rhabdomyolysis. Rhabdomyolysis may induce myocardial injury, aggravating kidney damage, and also increase transaminase concentration. Hemoperfusion and hemofiltration could be effective treatments for eliminating diquat in the blood. Frontiers Media S.A. 2022-10-24 /pmc/articles/PMC9638031/ /pubmed/36353285 http://dx.doi.org/10.3389/fpubh.2022.991587 Text en Copyright © 2022 Yu, Wang, Jian, Shi, Zhao, Li, Gao, Kan and Jian. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Yu, Guangcai
Wang, Jieru
Jian, Tianzi
Shi, Longke
Zhao, Liwen
Li, Yaqian
Gao, Yikai
Kan, Baotian
Jian, Xiangdong
Case series: Diquat poisoning with acute kidney failure, myocardial damage, and rhabdomyolysis
title Case series: Diquat poisoning with acute kidney failure, myocardial damage, and rhabdomyolysis
title_full Case series: Diquat poisoning with acute kidney failure, myocardial damage, and rhabdomyolysis
title_fullStr Case series: Diquat poisoning with acute kidney failure, myocardial damage, and rhabdomyolysis
title_full_unstemmed Case series: Diquat poisoning with acute kidney failure, myocardial damage, and rhabdomyolysis
title_short Case series: Diquat poisoning with acute kidney failure, myocardial damage, and rhabdomyolysis
title_sort case series: diquat poisoning with acute kidney failure, myocardial damage, and rhabdomyolysis
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9638031/
https://www.ncbi.nlm.nih.gov/pubmed/36353285
http://dx.doi.org/10.3389/fpubh.2022.991587
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