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A new understanding of acute poisoning by ingestion of diquat: paraquat′s twin brother——a summary of 6 cases and a review of the literature |
Zhao Xu-ming, Zhu Jian-jun, Zhu Jian-liang, Xiao Yan, Liu Li-jun |
Department of Emergency Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China |
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Abstract Objective To discuss the clinical features, treatment and prognosis of acute oral poisoning by diquat. Methods Review 6 cases of acute oral poisoning by diquat in our hospital and retrieve the previous case reports in domestic and foreign databases, then perform a summary analysis. Results According to the inclusion and exclusion criteria, a total of 27 patients were included. 14 patients were reported abroad. There are 15 male and 12 female. The average age was 32.5 years. The average oral dose was 17.4 g. The major toxic symptoms included: First, diquat directly damaged the musous membrane of the oropharynx and the digestive tract, mainly with mucous ulcer. Second, diquat was capable of multiple organ damage: kidney, lung, cardiovascular and brain. Most of them were acute injuries and a few were delayed. At present, gastric lavage, adsorption, catharsis and symptomatic treatments are routine measures. In this investigation, the blood purification rate was 70%, but glucocorticoid and immunosuppressive agents were used only in one report. The total mortality rate in this study is as high as 52%. Conclusion The clinical features of diquat are similar to those of paraquat; the patients with moderate and severe poisoning are prone to multiple organ dysfunction. There is no basis for the use of glucocorticoids. Although the evidence is insufficient, blood purification is a positive choice of treatment.
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Corresponding Authors:
Liu Li-jun, E-mail: lijunliusz@sina.com
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