Paraquat myopathy: report on two suicide cases.
We describe two suicide cases in which old paraquat was ingested. In conjunction with lung involvement a pronounced degeneration was observed in skeletal muscle of one who died on the 14th day after the ingestion. The following sarcoplasmic or endoplasmic reticulum Ca2+ ATPase (SERCA) monoclonal antibodies were used for skeletal muscle fiber typing by an immunohistochemical method: NCL-SERCA1, reactive with type 2 fiber (fast-twitch), and NCL-SERCA2, reactive with type 1 fiber (slow-twitch). The examination revealed that the remarkably degenerated fibers belonged to type 1 muscle fibers. This case showed an abrupt increase of plasma CK levels (1796 mU/ml) on the fifth day after the ingestion. The authors presume that the damage to the skeletal muscle had occurred in this period. The degeneration of the muscle seemed to be attributable to the long retention of paraquat in the tissue because these findings were not observed in the other case who died on the fifth day. Paraquat-induced myopathy may develop in prolonged paraquat poisoning. The examination of CK levels in plasma will be useful for diagnosis of damage of skeletal muscle.
Tabata
N
N
Department of Legal Medicine, School of Medicine, Sapporo Medical University, Japan.
Morita
M
M
Mimasaka
S
S
Funayama
M
M
Hagiwara
T
T
Abe
M
M
D000368:Aged; D001344:Autopsy / Q000379:methods*; D002423:Cause of Death; D003402:Creatine Kinase / Q000097:blood; D017809:Fatal Outcome; D005260:Female; D006540:Herbicides / Q000506:poisoning*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018485:Muscle Fibers, Skeletal / Q000473:pathology*; D009135:Muscular Diseases / Q000097:blood / Q000139:chemically induced* / Q000201:enzymology / Q000473:pathology*; D010269:Paraquat / Q000506:poisoning*; D013405:Suicide; D013997:Time Factors
D006540:Herbicides; D003402:Creatine Kinase; D010269:Paraquat