Kaala Pathar (Paraphenylene Diamine) Poisoning and Angioedema in a Child: An Unusual Encounter

Ishaque, Sidra; Haq, Anwar Ul; Jurair, Humaira; Siyal, Habib

doi:10.4172/2161-0495.1000294

Cited by 5 publications

(6 citation statements)

References 11 publications

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“…During the present investigations the toxic manifestations were further confirmed by Ultrasonography which revealed reduced size of kidneys with hepatic enlargement [22]. Prolonged use of PDD is known to induce cancer due to the mutagenicity of PDD and its metabolites [23].…”

Section: Case Reportmentioning

confidence: 66%

Para Phenylene Diamine Poisoning: Hepatic and Renal Damage

F¹,

S²,

Ghazanfar³

2017

J Women's Health Care

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Suicide is the second leading cause of death and it kills one person in every 40 seconds mostly between age limits 15-29 years. The global official surveys conducted reported higher death rates in low and middle income countries; however, women were affected more than men. Poisoning with chemicals is known to be a preferred method of suicide. The morbidity and mortality data following hair dye poisoning peaked in last few years. Interestingly, poisoning with Para Phenylene Diamine (PPD) is an emerging way of intentional self-harm in developing countries of Asia and Africa. We report here a case of 15 years old patient brought to our hospital emergency unit. The patient developed sudden onset of acute cervico-facial edema, lacrimation and abdominal pain, later followed by deranged liver and renal functions progressing towards liver and renal failure. The history selectively indicated the ingestion of a hair dye locally called "Kala Pathar" which predominantly contains PPD. The lack of specific diagnostic tests, a specific antidote for PPD poison and the importance of early supportive treatment are discussed.

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Section: Case Reportmentioning

confidence: 66%

Para Phenylene Diamine Poisoning: Hepatic and Renal Damage

F¹,

S²,

Ghazanfar³

2017

J Women's Health Care

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“…Any sign of neck swelling after PPD intoxication is an indication for an urgent tracheostomy; the swelling neck will collapse the patient’s airway if an immediate tracheostomy is not performed. In emergency settings, tracheostomy due to PPD intoxication is becoming one of the most common reasons for tracheostomy in southern Asia [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Frequency of Acute Hepatitis Following Acute Paraphenylene Diamine Intoxication

Ishtiaq

Shafiq

Ali

et al. 2017

Cureus

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IntroductionParaphenylene diamine (PPD) ingestion is manifesting as one of the more common ways of committing suicide in Southern Punjab, Pakistan, especially Bahawalpur. PPD is an ingredient of a compound commonly known “Kala Pathar” which means “Black Stone” in Urdu. It is readily available in the market at low cost and is used to dye hair and fur. Its intoxication inhibits cellular oxidation and affects the muscles causing rhabdomyolysis. This leads to myoglobinuria followed by renal failure and edema of face and throat resulting in respiratory difficulty. Very little is known about the impact of PPD intoxication on liver tissue.ObjectiveThe purpose of the study was to find out the frequency of acute hepatitis following PPD intoxication.MethodsWe reviewed the medical records of 109 patients with PPD intoxication admitted to Medical Unit-2, Bahawalpur Victoria Hospital from January 1, 2015, to June 30, 2015, in a descriptive, cross-sectional study. We noted the frequency of acute hepatitis and other complications, and we recorded the demographic features, clinical features, and outcomes of these patients.ResultsOur study included 32 men (29%) and 77 women (71%). The mean age was 22 ± 3.4 years, and most patients were young women aged 15 to 24 years. Suicidal ingestion was the leading cause of admission for 101 patients (93%). The most common clinical presentation was cervicofacial edema (95%), throat pain (88%), dysphonia (95%), cola-colored urine (100%), and oliguria (95%). Rhabdomyolysis (86%), acute hepatitis (51%), and acute renal failure (63%) were the most common clinical conditions following poisoning. Overall mortality was noted in 39 patients (36%) while all other patients achieved complete clinical recovery (64%). In patients with mortality, 20 of 39 (51%) developed acute hepatitis. Most patients (95%) in our study underwent tracheostomy.ConclusionThe frequency of acute hepatitis in PPD intoxication is high in this population, especially in young women. Measures need to be instituted regarding the management of acute hepatitis in PPD intoxication to improve patient outcomes. Workups in patients with PPD poisoning should include regular monitoring of aspartate aminotransferase and alanine aminotransferase to observe any damages to the liver so that acute hepatitis can be managed in a timely fashion.

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“…PPD is mainly used as an element of oxidative hair coloring products and temporary tattoos to fasten the dyeing process and produce a black color [11][12][13]. It can penetrate the hair shaft and undergo oxidative reactions, causing hair discoloration [14].…”

Section: Introductionmentioning

confidence: 99%

Erythematous Linear Lesion on the Course of Superficial Fibular Nerve After the Topical Application of Black Henna: A Case Report

Alkandari¹,

Alawadhi²,

Alawadhi³

et al. 2023

Cureus

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Henna is commonly used in body arts, where it produces orange-brown color. It is often mixed with chemicals such as para-phenylenediamine (PPD) to fasten the dyeing process and produce a black color. However, PPD has many allergic and toxic effects. We present a case of henna-induced cutaneous neuritis, which is not reported before. A 27-year-old female presented to our hospital, complaining of pain in her left great toe after applying black henna. Upon examination, the proximal nail fold was inflamed, and an erythematous non-palpable tender lesion was noticed on the dorsum of the foot. The lesion had an inverted-Y shape that was confined to the course of the superficial fibular nerve. Cutaneous nerve inflammation was favored after excluding all the anatomical structures in the region. Black henna should be avoided since it contains PPD, which can be absorbed through the skin and affect the underlying cutaneous nerves.

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Kaala Pathar (Paraphenylene Diamine) Poisoning and Angioedema in a Child: An Unusual Encounter

Cited by 5 publications

References 11 publications

Para Phenylene Diamine Poisoning: Hepatic and Renal Damage

Para Phenylene Diamine Poisoning: Hepatic and Renal Damage

Frequency of Acute Hepatitis Following Acute Paraphenylene Diamine Intoxication

Erythematous Linear Lesion on the Course of Superficial Fibular Nerve After the Topical Application of Black Henna: A Case Report

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