Clinical features and complication following Paraphenylenediamine poisoning: A Prospective clinical study

Manish Dudani; OP Jatav; Jitendra Agrawal

Volume : VIII, Issue : XII, December - 2018

Clinical features and complication following Paraphenylenediamine poisoning: A Prospective clinical study

Manish Dudani, Op Jatav, Jitendra Agrawal

Abstract :

Background: Poisoning is the main cause of High suicide rate in India and poisoning by hair dye is commonly seen, and in few places, it comprises a huge part of the poisoning cases.

Objective: To study the clinical features, electrocardiographic (ECG) changes, complications and outcome in patients presenting with hair dye poisoning.

Material and Methods: This prospective study comprises of 50 indoor patients admitted to poison ward of Department of Medicine, GR Medical College and JA Group of Hospitals, Gwalior, Madhya Pradesh, India. The parameters studied in all the patients were cause of ingestion, compound involved, time elapse between ingestion and admission to the hospital, duration of hospital stay, need for assisted ventilation, and cardiac manifestations at the time of presentation and during hospital stay. Routine investigations such as renal function, liver function tests,along with creatinine phosphokinase (CPK) levels, and cardiac marker test (CPK–MB) were done. ECG was done for all the patients daily to observe rate, rhythm, ST/T abnormalities, conduction defects, and P–R and Q–T intervals disturbances.

Result: Out of 50 patients included in the study, 38 (76%) patients were between the age group of 15–25 years, and there was a female predominance (60%). Twenty–eight (56%) patients reached hospital within 6 h of hair dye ingestion. Angioneurotic edema was the most common clinical finding. Renal functions were deranged in 38% and liver functions in 18% and CPK–MB was raised in 82% patients. ECG changes were observed in 90% patients of which ST/T changes were most common. Ten (20%) patients died in this study.

Conclusion: PPD poisoning was more common in females (60%) for suicide and is associated with effects on vital organs resulting in derangements of renal, hepatic and cardiac functions. ECG changes and elevated CPK–MB are found in majority of the patients with an overall mortality rate of 20%.