Evaluation of efficacy of resin hemoperfusion in patients with acute 2,4-dinitrophenol poisoning by dynamic monitoring of plasma toxin concentration

Abstract

Abstract:Objective: The intoxications caused by 2,4-dinitrophenol (2,4-DNP), even death, have been frequently reported in recent years. This study aims to investigate the dynamic changes of plasma toxin concentration and explore the clinical value of resin hemoperfusion (HP) in the treatment of patients with acute 2,4-DNP poisoning. Methods: We reported 16 cases of acute 2,4-DNP poisoning through occupational exposure due to ignoring the risk of poisoning. The blood samples were collected from the 14 survivors. According to the different treatments of resin HP, the survivors were divided into routine HP (n=5) and intensive HP (n=9) groups. Ultra high performance liquid chromatography/ tandem mass spectroscopy (UPLC-MS/MS) was used to detect the 2,4-DNP concentration in plasma in this study. Results: The 14 survivors recovered very well after treatment. The initial plasma 2,4-DNP concentrations (C 1 ) of survivors ranged from 0.25 to 41.88 µg/ml (mean (12.56±13.93) µg/ml). A positive correlation existed between initial plasma 2,4-DNP concentration (C 1 ) and temperature. The elimination of 2,4-DNP was slow and persistent, and the total clearance rates of plasma toxin from the 1st to 3rd day (R 3 ), the 3rd to 7th day (R 3-7 ), and the 1st to 7th day (R 7 ), were only (53.03±14.04)%, (55.25±10.50)%, and (78.29±10.22)%, respectively. The plasma toxin was cleared up to 25 d after poisoning in most of the patients. The R 3 , R 3-7 , and R 7 in the intensive HP group were all apparently higher than those in the routine HP group, with statistical significance (P<0.05). Simultaneously, the elimination half-life (t 1/2 ) of 2,4-DNP in the intensive HP group was apparently shorter than that in the routine HP group, with statistical significance (P<0.05). Conclusions: The clinicians should be aware of this slow and persistent process in the elimination of plasma 2,4-DNP. Higher initial plasma toxin concentration resulted in a more severe fever for the patient. According to the limited data, longer and more frequent resin HP may accelerate to eliminate the poison.

Anti-Obesity Therapy: from Rainbow Pills to Polyagonists

“…Although the weight-lowering effect of DNP is impressive, the margin between ED 50 and LD 50 is razor-thin. In line with this notion, acute administration of 20-50 mg/kg DNP can be lethal in humans (Macnab and Fielden, 1998;Hsiao et al, 2005), and its extended half-life that ranges from 46 hours in mice (Robert and Hagardorn, 1985) to 54-88 hours in humans (Zhao et al, 2015) further complicates its use. Repeated daily administration of DNP leads to accumulation, and with it the risk for fatal intoxication is increased.…”

Predictive value of the maximum serum creatinine value and growth rate in acute paraquat poisoning patients

“…Therefore, reliable and effective predictors of prognosis may be necessary to guide the treatments and future clinical research on specific antidotes and other therapies 7 . To date, several prognostic predictors have been reported to predict the outcome of acute PQ poisoning, such as patients’ plasma or urine PQ concentration, arterial lactate, abnormal pancreatic enzymes, hematological parameters, PQ ingestion volume, acute physiology and chronic health evaluation (APACHE) II score, sequential organ failure assessment (SOFA) score 8 – 19 . However, these indicators above have deficiencies to accurately predict prognosis, because of the limited availability and reliability.…”

On-Chip Facile Preparation of Monodisperse Resorcinol Formaldehyde (RF) Resin Microspheres

“…To test the adsorption ability of the porous RF microspheres, the methylene blue (MB) alcohol solution was taken as the adsorption model. As shown in Figure 6 , the methylene blue adsorption reached ~90% at 10 min, showing a high adsorption ability, which may be useful as absorbents for adsorbing large poisonous molecules, drug delivery, and pollution removal [ 25 , 26 ].…”