Intoxicação grave por paraquat: achados clínicos e radiológicos em um sobrevivente

Neves, Fábio Fernandes; Sousa, Romualdo Barroso de; Pazin‐Filho, Antônio; Cupo, Palmira; Júnior, Jorge Elias; Nogueira-Barbosa, Marcello Henrique

doi:10.1590/s1806-37132010000400019

Cited by 26 publications

(14 citation statements)

References 5 publications

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“…(33) In this study, Mate1+/+ and Mate1–/– mice were injected by tail vein with 50 mg/kg PQ as described elsewhere. 18,33−35 PQ was dissolved in 0.9% saline (the ratio of total paraquat to [ 14 C]-PQ was 130:1). Blood samples were collected by tail bleeding at 5, 10, 20, 30, 60, and 90 min after injection.…”

Section: Methodsmentioning

confidence: 99%

Deficiency of Multidrug and Toxin Extrusion 1 Enhances Renal Accumulation of Paraquat and Deteriorates Kidney Injury in Mice

Peng

Yang

et al. 2011

Mol. Pharmaceutics

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Multidrug and toxin extrusion 1 (MATE1/solute carrier 47A1) mediates cellular transport of a variety of structurally diverse compounds. Paraquat (PQ), which has been characterized in vitro as a MATE1 substrate, is a widely used herbicide and can cause severe toxicity to humans after exposure. However, the contribution of MATE1 to PQ disposition in vivo has not been determined. In the present study, we generated Mate1-deficient (Mate1–/–) mice and performed toxicokinetic analyses of PQ in Mate1–/– and wild-type (Mate1+/+) mice. After a single intravenous administration of PQ (50 mg/kg), Mate1–/– mice exhibited significantly higher plasma PQ concentrations than Mate1+/+ mice. The renal PQ concentration was markedly increased in Mate1–/– mice compared with Mate1+/+ mice. The subsequent nephrotoxicity of PQ were examined in these mice. Three days after intraperitoneal administration of PQ (20 mg/kg), the transcript levels of N-acetyl-β-d-glucosaminidase (Lcn2) and kidney injury molecule-1 (Kim-1) in the kidney were remarkably enhanced in the Mate1–/– mice. This was accompanied by apparent difference in renal histology between Mate1–/– and Mate1+/+ mice. In conclusion, we demonstrated that Mate1 is responsible for renal elimination of PQ in vivo and the deficiency of Mate1 function confers deteriorated kidney injury caused by PQ in mice.

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Section: Methodsmentioning

confidence: 99%

Deficiency of Multidrug and Toxin Extrusion 1 Enhances Renal Accumulation of Paraquat and Deteriorates Kidney Injury in Mice

Peng

Yang

et al. 2011

Mol. Pharmaceutics

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“…Pneumomediastinum was also shown to be an independent outcome indicator based on multiple Cox regression. To date, there were a total of 23 cases of pneumomediastinum in PQ poisoning reported [ 15 , 26 – 30 ], 17 of these patients were reported in 1991 by Im et al [ 14 ], and the other 6 cases was reported in case reports [ 26 – 30 ]. Out of 23 patients, 20 died within 3 days of its appearance [ 15 , 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

The Volume Ratio of Ground Glass Opacity in Early Lung CT Predicts Mortality in Acute Paraquat Poisoning

Kang

et al. 2015

PLoS ONE

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BackgroundPulmonary injury is the main cause of death in acute paraquat (PQ) poisoning. However, whether quantitative lung computed tomography (CT) can be useful in predicting the outcome of PQ poisoning remains unknown. We aimed to identify early findings of quantitative lung CT as predictors of outcome in acute PQ poisoning.MethodsLung CT scanning (64-slide) and quantitative CT lesions were prospectively measured for patients after PQ intoxication within 5 days. The study outcome was mortality during 90 days follow-up. Survival curves were derived by the Kaplan-Meier method, and mortality risk factors were analyzed by the forward stepwise Cox regression analysis.ResultsOf 97 patients, 41 (42.3%) died. Among the eight different types of lung CT findings which appeared in the first 5-day of PQ intoxication, four ones discriminated between survivors and non-survivors including ground glass opacity (GGO), consolidation, pneumomediastinum and “no obvious lesion”. With a cutoff value of 10.8%, sensitivity of 85.4% and specificity of 89.3%, GGO volume ratio is better than adopted outcome indicators in predicting mortality, such as estimated amount of PQ ingestion, plasma or urine PQ concentration, acute physiology and chronic health evaluation (APACHE) II and sequential organ failure assessment (SOFA) scores. GGO volume ratios above 10.8% were associated with increased mortality (hazard ratio, 5.82; 95% confidence interval, 4.77-7.09; P < 0.001).ConclusionsThe volume ratio of GGO exceeding 10.8% is a novel, reliable and independent predictors of outcome in acute PQ poisoning.

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“…[7] The combination of early identification of the culprit substance, avoidance of oxygen supplementation, and early administration of immunosuppressive therapy such as cyclophosphamide, methylprednisolone and dexamethasone has been described as associated with good outcomes. [8] Learning points…”

Section: In Practicementioning

confidence: 99%

Paraquat poisoning: Acute lung injury – a missed diagnosis

Ntshalintshali¹,

Manzini²

2017

S Afr Med J

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Intoxicação grave por paraquat: achados clínicos e radiológicos em um sobrevivente

Cited by 26 publications

References 5 publications

Deficiency of Multidrug and Toxin Extrusion 1 Enhances Renal Accumulation of Paraquat and Deteriorates Kidney Injury in Mice

Deficiency of Multidrug and Toxin Extrusion 1 Enhances Renal Accumulation of Paraquat and Deteriorates Kidney Injury in Mice

The Volume Ratio of Ground Glass Opacity in Early Lung CT Predicts Mortality in Acute Paraquat Poisoning

Paraquat poisoning: Acute lung injury – a missed diagnosis

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