title: Attempted suicide by ingestion of hair dye containing p-phenylenediamine: a case report.
abstract: Para-phenylenediamine is widely used as a chemical in hair dyes and in combination with henna. This dye is used to paint the body for decorative reasons, to speed the processing time of henna and to intensify the results. Para-phenylenediamine is widely used in the Middle East, North Africa and India. Several reports have been published of the fatal ingestion of hair dye containing para-phenylenediamine. Here, we describe the case of a 14-year-old girl who ingested the compound but whose prompt treatment prevented her death. Ingestion of para-phenylenediamine produces a typical triad of angioneurotic oedema, rhabdomyolysis and acute tubular necrosis. Awareness of signs of these associated conditions in our patient, together with a comprehensive history, facilitated appropriate treatment to be instituted. We document the steps we took to enable her complete physical recovery.
authors.affiliation: 1 Department of Internal Medicine, Omdurman Military Hospital, Khartoum, Sudan.
authors.forename: Lamis
authors.initials: L
authors.lastname: Beshir
authors.affiliation: 1 Department of Internal Medicine, Omdurman Military Hospital, Khartoum, Sudan.
authors.forename: Babiker
authors.initials: B
authors.lastname: Kaballo
authors.affiliation: 2 Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Donald
authors.initials: D
authors.lastname: Young
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000175:diagnosis / Q000473:pathology / Q000517:prevention & control*; D000293:Adolescent; D000799:Angioedema / Q000139:chemically induced / Q000175:diagnosis / Q000473:pathology / Q000517:prevention & control*; D002744:Chlorpheniramine / Q000627:therapeutic use; D005260:Female; D005440:Fluid Therapy; D005665:Furosemide / Q000627:therapeutic use; D006202:Hair Dyes / Q000506:poisoning*; D006801:Humans; D006854:Hydrocortisone / Q000031:analogs & derivatives / Q000627:therapeutic use; D009285:Naphthoquinones / Q000506:poisoning; D010655:Phenylenediamines / Q000506:poisoning*; D012121:Respiration, Artificial; D012206:Rhabdomyolysis / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D013406:Suicide, Attempted / Q000517:prevention & control* / Q000523:psychology; D014139:Tracheostomy
chemical_list: D006202:Hair Dyes; D009285:Naphthoquinones; D010655:Phenylenediamines; C039803:hydrocortisone sodium phosphate; D002744:Chlorpheniramine; D005665:Furosemide; C005090:lawsone; C029728:4-phenylenediamine; D006854:Hydrocortisone
keywords: acute tubular necrosis; angioneurotic oedema; creatine kinase; henna; p-Phenylenediamine poisoning; rhabdomyolysis