title: Clinical manifestations of systemic paraphenylene diamine intoxication.
abstract: BACKGROUND
  To report clinical symptoms and outcome of systemic paraphenylene diamine (PPD) intoxication.
  
  
  METHODS
  Our study was retrospective. It was conducted over 6 yrs (1994-2000) in the medical intensive care unit (ICU) of a university hospital and it concerned 19 patients hospitalized for systemic PPD intoxication.
  
  
  RESULTS
  The mean age (+/- SD) was 27.9 +/- 16.8 yrs, the sex ratio was about 0.58 and the Simplified Acute Physiology Score (SAPS II) was 30 +/- 27. At admission, clinical symptoms were dominated by cervicofacial edema (79%), chocolate brown colored urine (74%), upper airway tract edema (68.4%), oliguria (36.8%), muscular edema (26.3%) and shock (26.3%). The biological results were dominated by rhabdomyolysis (100%), metabolic acidosis (100%), acute renal failure (ARF) (47.4%) and hyperkalemia (26.3%) (biological disturbances were more pronounced in patients with ARF). The therapies used were gastric lavage (100%), fluid infusion (100%), mechanical ventilation (84.2%), alcalinization (80%), corticosteroids (84.2%), vasopressors (26.3%) and renal replacement therapy (26.3%). The intoxication evolution was marked by the death of six patients (31.6%); five of them had developed ARF. The mechanical ventilation duration and the ICU stay were both more prolonged in patients who developed ARF.
  
  
  CONCLUSIONS
  Clinical manifestations of systemic PPD intoxication were associated with respiratory, muscular, renal and hemodynamic syndromes. ARF occurrence testifies to the severity of the intoxication.
authors: Unit of Medical Resuscitation, CHU Habib Bourguiba, Sfax, Tunisia. kallelhat@yahoo.fr
authors: Hatem
authors: H
authors: Kallel
authors: Hedi
authors: H
authors: Chelly
authors: Hassen
authors: H
authors: Dammak
authors: Mabrouk
authors: M
authors: Bahloul
authors: Hichem
authors: H
authors: Ksibi
authors: Chokri Ben
authors: CB
authors: Hamida
authors: Adel
authors: A
authors: Chaari
authors: Noureddine
authors: N
authors: Rekik
authors: Marc E
authors: ME
authors: De Broe
authors: Mounir
authors: M
authors: Bouaziz
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000139:chemically induced* / Q000628:therapy; D000328:Adult; D004396:Coloring Agents / Q000506:poisoning*; D003402:Creatine Kinase / Q000097:blood; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005751:Gastric Lavage; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007362:Intensive Care Units; D016030:Kidney Transplantation; D008297:Male; D010655:Phenylenediamines / Q000506:poisoning*; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012206:Rhabdomyolysis / Q000097:blood / Q000139:chemically induced* / Q000628:therapy; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014508:Urea / Q000097:blood
chemical_list: D004396:Coloring Agents; D005938:Glucocorticoids; D010655:Phenylenediamines; D014508:Urea; D003404:Creatinine; D003402:Creatine Kinase; C029728:4-phenylenediamine