Combined initial cyclophosphamide with repeated methylprednisolone pulse therapy for severe paraquat poisoning from dermal exposure.
The article presents a patient with severe paraquat poisoning from dermal exposure, who had chemical bums to more than 10% of his body surface area, serum paraquat level 0.13 microg/mL 60 hr after exposure, and severe hypoxemia (PaO2 41.6 mmHg). The patient was successfully treated with combined initial megadoses of cyclophosphamide (15 mg/kg/day, total 2 days) with repeated methylprednisolone pulse therapy (15 mg/kg/day, total 6 days) and continuous dexamethasone administration (5 mg every 8 hr), and recovered completely without sequelae 3 months later. This treatment deserves further investigation in future clinical trials.
Lin
Nan-Chieh
NC
Poison Center, Department of Internal Medicine, Chang Gung Memorial Hospital, Lin-Kou Medical Center, Chang Gung Medical College and University, Taipei, Taiwan, ROC.
Lin
Ja-Liang
JL
Lin-Tan
Dan-Tzu
DT
Yu
Chun-Chen
CC
D000328:Adult; D000428:Alcohol Drinking; D000477:Alkylating Agents / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002057:Burns, Chemical / Q000188:drug therapy / Q000473:pathology; D003520:Cyclophosphamide / Q000627:therapeutic use*; D003907:Dexamethasone / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006540:Herbicides / Q000506:poisoning*; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D010269:Paraquat / Q000506:poisoning*; D012867:Skin / Q000473:pathology
D000477:Alkylating Agents; D000893:Anti-Inflammatory Agents; D006540:Herbicides; D003907:Dexamethasone; D003520:Cyclophosphamide; D010269:Paraquat; D008775:Methylprednisolone