Paraquat Tongue as an Infrequent Complication in Paraquat Intoxication

巴拉刈中毒患者的罕見表現：巴拉刈舌頭

王偉傑(Wei-Jie Wang) ； 林瑞祥(Jui-Hsiang Lin) ； 鄭美華(Mei-Hua Cheng) ； 鄭爵儀(Chueh-Yi Cheng)

《醫學與健康期刊》 8卷2期 (2019/09) Pp. 99-103

摘要

Paraquat tongue is a rare manifestation of paraquat poisoning. This study reports a case of multiple ulcerations in the tongue of a 31-year-old depressed man who attempted suicide by ingesting a paraquat solution. Chest radiography showed diffuse ground glass opacities of both lungs with a thickening of the intralobular interstitium, compatible with interstitial pneumonitis. Urine paraquat was 10mg/mL. The patient was treated with an immediate detoxification by gastric lavage, active charcoal, charcoal hemoperfusion, pulse therapies of cyclophosphamide (15mg/kg/day for 2 days) and methylprednisolone pulse therapies (1g/day for 3 days), followed by prolonged dexamethasone therapy (20mg/day for 14 days), resulting a favorable prognosis. Furthermore, early intensive detoxification, the mainstay treatment, proved to effective in our case.

關鍵字

Paraquat ； Paraquate tongue ； Cyclophosphamide

並列摘要

巴拉刈中毒患者的預後通常都不好，巴拉刈舌頭更是巴拉刈中毒患者的罕見表現之一。一名31歲的抑鬱症男子因服用巴拉刈除草劑自殺而導致的多處舌頭潰瘍，胸部X光顯現大量的毛玻璃樣斑塊合併肺葉間質性增厚與間質性肺炎，尿液巴拉刈濃度為10mg/dL。因此立即根據巴拉刈解毒指引給予活性炭洗胃並且執行血液灌流術合併環磷醯胺與類固醇脈衝療法。巴拉刈中毒早期依據巴拉刈解毒指引去治療可以有效提高巴拉刈中毒患者的預後。

並列關鍵字

巴拉刈 ； 巴拉刈舌頭 ； 環磷醯胺

參考文獻

Hsieh YW, Lin JL, Lee SY, et al.: Paraquat Poisoning in Pediatric Patients. Pediatr Emer Care 2013;29:487-91.

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Weng CH, Hu CC, Lin JL, et al.: Sequential Organ Failure Assessment Score Can Predict Mortality in Patients with Paraquat Intoxication. PLoS ONE 2012;7: e51743.

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Lin JL, Lin-Tan DT, Chen KH, Huang WH: Repeated pulse of methylprednisolone and cyclophosphamide with continuous dexamethasone therapy for patients with severe paraquat poisoning. Crit Care Med 2006;34:368-73.