High-dose cyclophosphamide and dexamethasone in paraquat poisoning: a prospective study.
Between March 1986 and March 1988, 47 consecutive patients, whose paraquat intoxication was confirmed by urine testing, were enrolled in a prospective study on the treatment of paraquat poisoning. Fourteen received a standard treatment regimen consisting of fluid replacement and oral absorbents, and 33 received high-dose cyclophosphamide and dexamethasone, in addition to standard therapy. The case fatality rate in both treatment groups (63 and 61%) was similar. In addition, all 26 patients whose paraquat serum concentrations were measured and who had a probability of survival of less than 65% according the survival curve of Hart et al. died, regardless of therapy. These included four in the cyclophosphamide/dexamethasone group and two in the standard treatment group who had prior survival probabilities between 50 and 65%. This indicated that the cut-off curve relating mortality and paraquat serum concentrations was similar in both treatment groups. High-dose cyclophosphamide/dexamethasone treatment is unlikely to improve the prognosis of paraquat poisoning.
Department of Internal Medicine, Akademisch Ziekenhuis, Paramaribo, Suriname.
J H
JH
Perriëns
S
S
Benimadho
I L
IL
Kiauw
J
J
Wisse
H
H
Chee
D000293:Adolescent; D000328:Adult; D000368:Aged; D003520:Cyclophosphamide / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010269:Paraquat / Q000097:blood / Q000506:poisoning*; D011041:Poisoning / Q000188:drug therapy; D011446:Prospective Studies
D003907:Dexamethasone; D003520:Cyclophosphamide; D010269:Paraquat