Patients with mild paraquat poisoning treated with prolonged low-dose methylprednisolone have better lung function

Abstract

Lung dysfunction is an important characteristic of injury induced by paraquat (PQ). This study aimed to evaluate the effects of prolonged low-dose methylprednisolone (MP) treatment on lung function in patients with mild PQ poisoning. We analyzed the results of lung function testing in all patients with mild PQ poisoning admitted to Cangzhou Central Hospital between January 2012 and August 2017. Patients were grouped according to short-term treatment (3 mg/kg/day MP for 3 days) or prolonged treatment (3 mg/kg/day MP for 3 days, followed by dosage reduction by half every 3 days, with treatment terminated when a dosage of 0.375 mg/kg/day was reached). Lung function was evaluated at 2 to 3 months after PQ exposure. The forced expiratory volume in 1 second (85.72 ± 4.93% vs 78.41 ± 4.58%; P < .001), forced vital capacity (81.98 ± 4.93% vs 77.85 ± 4.37%; P < .001), and diffusing capacity (84.27 ± 5.16% vs 76.21 ± 3.71%; P < .001) in the prolonged low-dose MP group were improved compared with those in the short-term MP group. Patients with mild PQ poisoning treated with prolonged low-dose MP had better lung function 2 to 3 months after PQ poisoning.

Follow-up of patients with a 5-year survival after paraquat poisoning using computed tomography images and spirometry

“…The results were different from previous reports, which considered that restrictive type of pulmonary dysfunction was mainly left in survivors of paraquat poisoning. 12,13 Five patients with severe ventilatory dysfunction were further analyzed. The MMEF 75%/25% was significantly decreased, indicating increased small airway resistance.…”

“…The results were different from previous reports, which considered that restrictive type of pulmonary dysfunction was mainly left in survivors of paraquat poisoning. 12,13 Five patients with severe ventilatory dysfunction were further analyzed. The MMEF 75%/ 25% was significantly decreased, indicating increased small Presumably, paraquat poisoning can cause inflammatory response and oxidative stress, inducing allergic inflammatory factors and releasing smooth muscle contractions, 14 leading to airway hyperresponsiveness.…”

A novel flowchart to predict mortality and analyse effectiveness of routinely used pharmacological regimens in paraquat poisoning

“…23 Less degraded lung function after prolonged low-dose methylprednisolone use also seems possible. 24 Prolonged methylprednisolone use after pulse therapy has been suggested to reduce mortality in moderately to severely paraquat-poisoned patients. 25 However, prospective studies to clarify the clinical contribution of methylprednisolone in paraquat poisoning are needed.…”

Monocytes as an Early Predictor for Patients with Acute Paraquat Poisoning: A Retrospective Analysis

“…This initial phase is followed by a proliferative phase where the alveolar space is filled with mononuclear profibroblasts that mature into fibroblasts within days to weeks. Previous studies showed that patients with PQ poisoning may be left with less diffusion dysfunction and restriction ventilation dysfunction at 2 to 3 months, and long-term follow-up suggests that respiratory function impairment usually fully recovers [39, 40]. High-resolution computed tomography revealed small cystic and linear shadows at the end of the first week, preponderant parenchymal abnormality after 2–4 weeks, focal honeycombing after 4 weeks, localized fibrosis containing small cysts at 9 months, and disappeared cystic changes at 1–2 years after PQ poisoning [41, 42].…”