RESUMEN
Objective: To determine the clinical presentation, complications, and outcome of paraphenylene diamine [PPD] poisoning in patients presenting to Nishtar Hospital, Multan. Study Design: Descriptive study. Place and Duration of Study: Medical Unit II and III, Nishtar Hospital, Multan, from April 2015 to September 2016
Methodology: All adult patients admitted with history of paraphenylene diamine ingestion were evaluated for clinical features, complications, and outcomes on a pre-designed proforma
Results: Out of 122 patients, 95 were females [77.9%] and 101/122 patients had ingested the poison with an intention of suicide or self harm [82.8%]. The mean age of presentation was 23.21 +/-8.2 years. Cervico-facial edema was the chief presenting complaint, seen in 116/122 [95%] of patients, with median of 2 [interquartile range=3] for time of onset after ingestion of poison. Tracheostomy was needed in 95/116 [82%] patients with cervico-facial edema. Other common complaints were dark urine in 95/122 [77.9%] and pain in limbs in 98/122 [80.3%] patients. Rhabdomyolysis was evident in 91/122 [74.5%] patients at admission. Acute kidney injury developed in 37/122 [30.3%] patients. Among these, 16 [43.2%] patients required haemodialysis. Myocarditis was diagnosed in 33/122 [27%] patients. The median for hospital stay was 9.50 days [interquartile range=6.25]. The mortality was 34/122 [28%]. Ventricular arrhythmias were the commonest cause of death in 25/34 [73.5%], followed by renal failure in 5/34 [14.7%], asphyxia in 2/34 [5.88%], and aspiration pneumonia in 2/34 [5.88%] patients
Conclusion: Paraphenylene diamine is an emerging domestic poison in Pakistan, with a high morbidity and mortality