ABSTRACT
Introduction: Paraphynylenediamine (PPD) in hair dye causes angioneurotic edema leading to acute respiratory distress, rhabdomyolysis, i.e. necrosis of skeletal muscle resulting in acute renal failure and liver injury upon ingestion. We studied the time course of treatment on organ damage markers such as plasma Creatine phosphokinase (CPK), Lactate dehydrogenase (LDH) and Total leukocyte count (TLC) of these patients till discharge. Materials and methods: We reviewed the case records of 10 Patients of suicidal hair dye poisoning. Data was collected in pre-specified data collection forms regarding WBC count, CPK levels, age, gender, time to index admission, ventilator support, the volume of ingestion and outcome. We followed the values of CPK and TLC of these patients till discharge. Results: The average age was 25.8±10.5, the mean volume of consumption of hair die was 102.5±17.5, and time to reach emergency room was 7.6±3.2 hours. On arrival, all patients were intubated and received gastric lavage, antihistamines, parenteral steroids, and sodium bicarbonate. Duration of ventilator support was 2.9±0.7 days and length of hospital stay was 10.1±2.7 days. At admission, CPK, TLC, and LDH were elevated, during hospital stay values CPK, LDH and TLC gradually decreased by day-5 after that they showed a marginal increase by day-7. Conclusion: We observed significantly elevated levels of CPK, LDH and TLC at index admission after oral ingestion of hair dye suggesting muscle, hepatic and hematological injury. The rate of decline of these values (recovery) is parallel.
ABSTRACT
Hair dye poisoning which was uncommon is now raising an alarm in the field of toxicology. It leads to acute angioedema causing airway compromise, thus making it life threatening. It also leads to acute renal failure and multi organ damage. Failure in prompt recognition and timely management may lead to death. We report a 24 year old female who was brought to us six hours after consuming hair dye. She had difficulty in breathing and was unable to talk. Her tongue, submandibular region and neck were oedematous. Resuscitation measures were taken and she was intubated with great effort. Appropriate anaphylaxis treatment along with forced alkaline diuresis to prevent renal damage led to the betterment of her condition.
ABSTRACT
We report a patient who developed acute renal failure following the ingestion of a hair-dye with a suicidal intent. He was managed by hemodialysis and other symptomatic measures. He developed generalized seizures and underwent MRI scan of the brain using gadolinium containing contrast material followed by development of bilateral and symmetrical thickening and induration of the skin over the extremities and verrucous papules and plaques over the lower back. Skin biopsy and immunohistochemistry showed typical features of nephrogenic fibrosing dermopathy as well as deposits of calcium. Successful management of renal failure resulted in clearing of all skin lesions except a small bony hard plate like area overt the left leg, the biopsy of which showed features of osseous metaplasia.