[Rhabdomyolysis and paraphenylene-diamine poisoning].
OBJECTIVE
The aim of this study is to describe clinical description, biological findings, outcome and prognostic factors of paraphenylene-diamine poisoning.


METHODS
We report a cohort study spreaded over 6 years (1999-2004), realized in Medical Intensive Care Unit in Ibn-Rochd University Hospital at Casablanca (Morocco). This study included 315 patients admitted for paraphenylene-diamine (PPD) poisoning. Diagnosis was based on: poisoning reported by the patient or his family, clinical data, biological findings and qualitative determination of PPD. Epidemiological parameters was obtained at admission. Every day, clinical and biological data, therapy and gravity scores were collected and a mean was calculated.


RESULTS
315 patients were admitted over this period. The mean age was 23+/-9 years. We noticed a clear female predominance (sex-ratio=9.86). The intoxication was voluntarily aiming at autolysis in 93.3% of the cases. The patients were admitted at about 5+/-5.3 hours after the intoxication. The clinical chart was at first dominated by the respiratory and renal symptoms. The mean of CPK was 132,351.8+/-164,978 UI/l. The treatment was especially symptomatic. The mortality was 47%. The multivariate analysis concluded that acid urinary pH, hyperglycaemia, hard muscles, betamimetic drugs and MPM II>0.14 were associated with a poor prognosis.


CONCLUSIONS
The PPD poisoning represents the first cause of toxic rhabdomyolysis in our context and responsible of high mortality. For that, it's necessary to control PPD trade, to inform the medical persons and a rapid management.
Motaouakkil
S
S
Service de réanimation médicale, CHU Ibn-Rochd, Casablanca, Maroc. smotaouakkil@yahoo.fr
Charra
B
B
Hachimi
A
A
Ezzouine
H
H
Guedari
H
H
Nejmi
H
H
Benslama
A
A
D000293:Adolescent; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000328:Adult; D001329:Autolysis / Q000188:drug therapy; D015331:Cohort Studies; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D006943:Hyperglycemia / Q000139:chemically induced / Q000628:therapy; D007362:Intensive Care Units; D007674:Kidney Diseases / Q000139:chemically induced / Q000628:therapy; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D010655:Phenylenediamines / Q000506:poisoning*; D011379:Prognosis; D012129:Respiratory Function Tests; D012140:Respiratory Tract Diseases / Q000139:chemically induced / Q000628:therapy; D012206:Rhabdomyolysis / Q000139:chemically induced*; D016896:Treatment Outcome
D000318:Adrenergic beta-Agonists; D010655:Phenylenediamines