چكيده لاتين :
Background: Paraquat is a bipyridil herbicide and in appropriate and careful usage, will not
be health threatening. Most adult cases of intoxication are due to suicidal attempts rather than
accidental exposure. Therapeutic response has been reported to be appropriate with high doses
of cyclophosphamide and glucocorticoids and survival is reported to be approximately 75 %. So,
this study was designed to evaluate the effects of combined treatment with cyclophosphamide
and glucocorticoids in patients with paraquat poisoning.
Methods: During a two-year period 45 patients with paraquat poisoning were admitted to Sina
Hospital, Hamadan, Iran, of whom 20 had moderate to severe intoxication. Eleven patients (group
1) received conventional treatment and nine patients (group 2) received conventional treatment
plus intravenous infusions of cyclophosphamide 15 mg/kg daily for two days, methylprednisolone
one gram daily for three days, and mesna 15 mg/kg for four days.
Results: The mean age±SD in group 1 was 25±10 years and in group 2 was 26±10 years. In
group 1 three patients were females and eight patients were males. In group 2 one patient was
female and eight patients were males. There were no differences between the groups in the time
elapsed from ingestion to presentation at hospital or in the beginning of hemodialysis. The
mortality rate in group 1 was 81.8% and in group 2 was 33.3% (P< 0.05). All fatalities caused by
acute respiratory distress syndrome.
Conclusion: Pulse therapy with cyclophosphamide and methylprednisolone may be effective
in preventing respiratory failure and reducing mortality in patients with moderate to severe
paraquat poisoning.
