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Efficacy of deferoxamine on paraquat poisoning  

Huh, Jin Won (Department of Internal Medicine, Inje University)
Jegal, Yangjin (Department of Internal Medicine, University of Ulsan)
Hong, Sang-Bum (Division of Pulmonary and Critical Care Medicine, Asan Medical Center University of Ulsan College of Medicine)
Oh, Yeon Mok (Division of Pulmonary and Critical Care Medicine, Asan Medical Center University of Ulsan College of Medicine)
Shim, Tae Sun (Division of Pulmonary and Critical Care Medicine, Asan Medical Center University of Ulsan College of Medicine)
Lim, Chae-Man (Division of Pulmonary and Critical Care Medicine, Asan Medical Center University of Ulsan College of Medicine)
Lee, Sang Do (Division of Pulmonary and Critical Care Medicine, Asan Medical Center University of Ulsan College of Medicine)
Kim, Woo Sung (Division of Pulmonary and Critical Care Medicine, Asan Medical Center University of Ulsan College of Medicine)
Kim, Dong Soon (Division of Pulmonary and Critical Care Medicine, Asan Medical Center University of Ulsan College of Medicine)
Kim, Won Dong (Division of Pulmonary and Critical Care Medicine, Asan Medical Center University of Ulsan College of Medicine)
Koh, Younsuck (Division of Pulmonary and Critical Care Medicine, Asan Medical Center University of Ulsan College of Medicine)
Publication Information
Tuberculosis and Respiratory Diseases / v.62, no.2, 2007 , pp. 113-118 More about this Journal
Abstract
Background: Paraquat is known to induce oxidant injury that results in multiorgan failure and lung fibrosis. Iron has been considered to play a key role in paraquat-induced oxidant lung injury. This study examined the effect of deferoxamine, an iron-chelating agent, in the treatment of paraquat poisoning. Methods: From September, 2001 to April, 2005, 28 patients with paraquat poisoning who were admitted at a medical intensive care unit of a University-affiliated hospital, were enrolled in this study. Sixteen patients were treated according to the paraquat poisoning treatment guidelines and 12 received an intravenous infusion of deferoxamine in addition to the treatment guidelines. Results: There were no differences between the two groups in terms of age, gender, severity of paraquat poisoning, and the time elapsed from ingestion to presentation at hospital. There was no difference in overall mortality between the two groups but the incidence of respiratory failure in the deferoxamine group was higher than in the conventional group(4/7 versus 0/9, p=0.019). Conclusion: Deferoxamine seems to have no clinical benefit compared with the conventional treatment.
Keywords
Paraquat; Deferoxamine; Mortality;
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1 Fock KM. Clinical features and prognosis of paraquat poisoning: a review of 27 cases. Singapore Med J 1987;28:53-6
2 Addo E, Ramdial S, Poon-King T. High dosage cyclophosphamide and dexamethasone treatment of paraquat poisoning with 75% survival. West Indian Med J 1984;33:220-6
3 van Asbeck BS, Hillen FC, Boonen HC, de Jong Y, Dormans JA, van der Wal NA, et al. Continuous intravenous infusion of deferoxamine reduces mortality by paraquat in vitamin E-deficient rats. Am Rev Respir Dis 1989;139:769-73   DOI   ScienceOn
4 Huh JW, Hong SB, Lim CM, Do KH, Lee JS, Koh Y. Sequential radiologic and functional pulmonary changes in patients with paraquat intoxication. Int J Occup Environ Health 2006;12:203-8   DOI
5 Carr A, Frei B. Does vitamin C act as a pro-oxidant under physiological conditions? FASEB J 1999;13: 1007-24   DOI
6 Hershko C, Weatherall DJ. Iron-chelating therapy. Crit Rev Clin Lab Sci 1988;26:303-45   DOI   ScienceOn
7 Kang SA, Jang YJ, Park H. In vivo dual effects of vitamin C on paraquat-induced lung damage: dependence on released metals from the damaged tissue. Free Radic Res 1998;28:93-107   DOI   ScienceOn
8 Perriens JH, Benimadho S, Kiauw IL, Wisse J, Chee H. High-dose cyclophosphamide and dexamethasone in paraquat poisoning: a prospective study. Hum Exp Toxicol 1992;11:129-34   DOI   ScienceOn
9 van der Wal NA, van Oirschot JF, van Dijk A, Verhoef J, van Asbeck BS. Mechanism of protection of alveolar type II cells against paraquat-induced cytotoxicity by deferoxamine. Biochem Pharmacol 1990;39: 1665-71   DOI   ScienceOn
10 Suzuki K, Takasu N, Okabe T, Ishimatsu S, Ueda A, Tanaka S, et al. Effect of aggressive haemoperfusion on the clinical course of patients with paraquat poisoning. Hum Exp Toxicol 1993;12:323-7   DOI   ScienceOn
11 Koo JR, Kim JC, Yoon JW, Kim GH, Jeon RW, Kim HJ, et al. Failure of continuous venovenous hemofiltration to prevent death in paraquat poisoning. Am J Kidney Dis 2002;39:55-9   DOI   ScienceOn
12 Proudfoot AT, Stewart MS, Levitt T, Widdop B. Paraquat poisoning: significance of plasma-paraquat concentrations. Lancet 1979;2:330-2
13 van der Wal NA, Smith LL, van Oirschot JF, van Asbeck BS. Effect of iron chelators on paraquat toxicity in rats and alveolar type II cells. Am Rev Respir Dis 1992;145:180-6   DOI   ScienceOn
14 Lheureux P, Leduc D, Vanbinst R, Askenasi R. Survival in a case of massive paraquat ingestion. Chest 1995;107:285-9   DOI   ScienceOn
15 Buettner GR, Jurkiewicz BA. Catalytic metals, ascorbate and free radicals: combinations to avoid. Radiat Res 1996;145:532-41   DOI   ScienceOn
16 Lin JL, Leu ML, Liu YC, Chen GH. A prospective clinical trial of pulse therapy with glucocorticoid and cyclophosphamide in moderate to severe paraquatpoisoned patients. Am J Respir Crit Care Med 1999;159:357-60   DOI   ScienceOn
17 Hwang KY, Lee EY, Hong SY. Paraquat intoxication in Korea. Arch Environ Health 2002;57:162-6   DOI   ScienceOn
18 Addo E, Poon-King T. Leucocyte suppression in treatment of 72 patients with paraquat poisoning. Lancet 1986;1:1117-20
19 Tsatsakis AM, Perakis K, Koumantakis E. Experience with acute paraquat poisoning in Crete. Vet Hum Toxicol 1996;38:113-7
20 Osheroff MR, Schaich KM, Drew RT, Borg DC. Failure of desferrioxamine to modify the toxicity of paraquat in rats. J Free Radic Biol Med 1985;1:71-82   DOI   ScienceOn
21 Kohen R, Chevion M. Paraquat toxicity is enhanced by iron and reduced by desferrioxamine in laboratory mice. Biochem Pharmacol 1985;34:1841-3   DOI   ScienceOn
22 Hong SY, Yang DH, Hwang KY. Associations between laboratory parameters and outcome of paraquat poisoning. Toxicol Lett 2000;118:53-9   DOI
23 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;51:661-3   DOI   ScienceOn
24 Tenenbein M, Kowalski S, Sienko A, Bowden DH, Adamson IY. Pulmonary toxic effects of continuous desferrioxamine administration in acute iron poisoning. Lancet 1992;339:699-701   DOI   ScienceOn
25 Suzuki K, Takasu N, Arita S, Maenosono A, Ishimatsu S, Nishina M, et al. A new method for predicting the outcome and survival period in paraquat poisoning. Hum Toxicol 1989;8:33-8   DOI
26 Poot M, Rabinovitch PS, Hoehn H. Free radical mediated cytotoxicity of desferrioxamine. Free Radic Res Commun 1989;6:323-8   DOI