Advanced search
Publication Cover
Clinical Toxicology Volume 56, 2018 - Issue 7
Submit an article Journal homepage
3,479
Views
26
CrossRef citations to date
0
Altmetric
Clinical Research

High-dose immunosuppression to prevent death after paraquat self-poisoning – a randomised controlled trial

Indika GawarammanaDepartment of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka; ;South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka; ORCID Iconhttp://orcid.org/0000-0001-6795-0113
ORCID Icon,
Nicholas A. BuckleySouth Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka; ;Department of Pharmacology, University of Sydney, Sydney, Australia; ;Royal Prince Alfred Hospital, Sydney, Australia; Correspondence[email protected]
ORCID Iconhttp://orcid.org/0000-0002-6326-4711
ORCID Icon,
Fahim MohamedSouth Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka; ;Department of Pharmacology, University of Sydney, Sydney, Australia; ORCID Iconhttp://orcid.org/0000-0003-2849-7269
ORCID Icon,
Kamal NaserPeradeniya Hospitals, Peradeniya, Sri Lanka;
,
K. JeganathanAnuradhapura Hospitals, Anuradhapura, Sri Lanka; ;Rathnapura Hospitals, Rathnapura, Sri Lanka;
,
P. L. AriyananadaFaculty of Medicine, University of Ruhuna, Galle, Sri Lanka;
,
Klintean WunnapukTherapeutics Research Centre, School of Medicine, University of Queensland, Brisbane, Australia; ;Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand;
,
Timothy A. DobbinsDepartment of Pharmacology, University of Sydney, Sydney, Australia; ;National Drug and Alcohol Research Centre, Sydney, Australia;
,
John A. TomensonCausation Limited, Macclesfield, UK;
,
Martin F. WilksSwiss Centre for Applied Human Toxicology, University of Basel, Basel, Switzerland;
,
Michael EddlestonSouth Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka; ;Department of Pharmacology, Toxicology and Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh and National Poisons Information Service – Edinburgh Unit, Royal Infirmary of Edinburgh, Edinburgh, UKORCID Iconhttp://orcid.org/0000-0002-6857-3441
ORCID Icon &
Andrew H. DawsonSouth Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka; ;Department of Pharmacology, University of Sydney, Sydney, Australia; ;Royal Prince Alfred Hospital, Sydney, Australia; ORCID Iconhttp://orcid.org/0000-0002-8047-397X
ORCID Icon show all
Pages 633-639 | Received 22 Jul 2017, Accepted 25 Sep 2017, Published online: 03 Nov 2017

References

  • Jeyaratnam J. Acute pesticide poisoning: a major global health problem. World Health Stat Q. 1990;43:139–144.
  • Eddleston M, Phillips MR. Self poisoning with pesticides. BMJ. 2004;328:42–44.
  • Gunnell D, Eddleston M, Phillips MR, et al. The global distribution of fatal pesticide self-poisoning: systematic review. BMC Public Health. 2007;7:357.
  • Dawson AH, Eddleston M, Senarathna L, et al. Acute human lethal toxicity of agricultural pesticides: a prospective cohort study. PLoS Med. 2010;7:e1000357.
  • Patel V, Ramasundarahettige C, Vijayakumar L, et al. Suicide mortality in India: a nationally representative survey. Lancet. 2012;379:2343–2351.
  • Eddleston M. Patterns and problems of deliberate self-poisoning in the developing world. QJM. 2000;93:715–731.
  • Yin Y, Guo X, Zhang SL, et al. Analysis of paraquat intoxication epidemic (2002–2011) within China. Biomed Environ Sci. 2013;26:509–512.
  • Chang SS, Lu TH, Eddleston M, et al. Factors associated with the decline in suicide by pesticide poisoning in Taiwan: a time trend analysis, 1987-2010. Clin Toxicol. 2012;50:471–480.
  • Gawarammana IB, Buckley NA. Medical management of paraquat ingestion. Br J Clin Pharmacol. 2011;72:745–757.
  • Addo E, Poon-King T. Leucocyte suppression in treatment of 72 patients with paraquat poisoning. Lancet. 1986;1:1117–1120.
  • Lin JL, Leu ML, Liu YC, et al. A prospective clinical trial of pulse therapy with glucocorticoid and cyclophosphamide in moderate to severe paraquat-poisoned patients. Am J Respir Crit Care Med. 1999;159:357–360.
  • Lin JL, Wei MC, Liu YC. Pulse therapy with cyclophosphamide and methylprednisolone in patients with moderate to severe paraquat poisoning: a preliminary report. Thorax. 1996;51:661–663.
  • Lin JL, Lin-Tan DT, Chen KH, et al. Repeated pulse of methylprednisolone and cyclophosphamide with continuous dexamethasone therapy for patients with severe paraquat poisoning. Crit Care Med. 2006;34:368–373.
  • Eddleston M, Wilks MF, Buckley NA. Prospects for treatment of paraquat-induced lung fibrosis with immunosuppressive drugs and the need for better prediction of outcome: a systematic review. QJM. 2003;96:809–824.
  • Scherrmann JM, Houze P, Bismuth C, et al. Prognostic value of plasma and urine paraquat concentration. Hum Toxicol. 1987;6:91–93.
  • Wilks MF, Fernando R, Ariyananda PL, et al. Improvement in survival after paraquat ingestion following introduction of a new formulation in Sri Lanka. PLoS Med. 2008;5:e49.
  • Knepil J. Measurement of plasma-paraquat concentration. Lancet. 1979;2:699.
  • Wunnapuk K, Medley GA, Liu X, et al. Simple and sensitive liquid chromatography-tandem mass spectrometry methods for quantification of paraquat in plasma and urine: application to experimental and clinical toxicological studies. J Chromatogr B Analyt Technol Biomed Life Sci. 2011;879:3047–3052.
  • Proudfoot AT, Stewart MS, Levitt T, et al. Paraquat poisoning: significance of plasma-paraquat concentrations. Lancet. 1979;314: 330–332.
  • Sawada Y, Yamamoto I, Hirokane T, et al. Severity index of paraquat poisoning. Lancet. 1988;1:1333.
  • Senarathna L, Eddleston M, Wilks MF, et al. Prediction of outcome after paraquat poisoning by measurement of the plasma paraquat concentration. QJM. 2009;102:251–259.
  • Li LR, Sydenham E, Chaudhary B, et al. Glucocorticoid with cyclophosphamide for paraquat-induced lung fibrosis. Cochrane Database Syst Rev. 2014;8:CD008084.
  • Perriens JH, Benimadho S, Kiauw IL, et al. High-dose cyclophosphamide and dexamethasone in paraquat poisoning: a prospective study. Hum Exp Toxicol. 1992;11:129–134.
  • Ghorbani A, Masoumi K, Forouzan A, etet al. Effect of pulse therapy with glucocorticoids and cyclophosphamide in patients with paraquat poisoning. Hong Kong J Emerg Med. 2015;22:235–240.
  • Wu WP, Lai MN, Lin CH, et al. Addition of immunosuppressive treatment to hemoperfusion is associated with improved survival after paraquat poisoning: a nationwide study. PLoS One. 2014;9:e87568.
  • Dinis-Oliveira RJ, Duarte JA, Remiao F, et al. Single high dose dexamethasone treatment decreases the pathological score and increases the survival rate of paraquat-intoxicated rats. Toxicology. 2006;227:73–85.
  • Yeh ST, Guo HR, Su YS, et al. Protective effects of N-acetylcysteine treatment post-acute paraquat intoxication in rats and in human lung epithelial cells. Toxicology. 2006;223:181–190.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Order Reprints Request Corporate Permissions

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

Request Academic Permissions

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.

Related research

People also read lists articles that other readers of this article have read.

Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine.

Cited by lists all citing articles based on Crossref citations.
Articles with the Crossref icon will open in a new tab.