Clinical and pathological profile of paraquat poisoning cases - A cross-sectional study in Odisha, India

Abstract

Agriculture being the primary mode of occupation in Odisha leads to the rampant and widespread use of chemical pesticides and herbicides. Paraquat is a widely used herbicide. Ingestion of PQ irrespective of the quantity could be fatal with life-threatening effects on the gastrointestinal (GI) tract, kidney, liver, lungs, and other organs. Death is usually associated with respiratory insufficiency due to an oxidative insult to the Type-II alveolar epithelium with subsequent fibrosis.All cases of paraquat ingestion coming to AIIMS, Bhubaneswar casualty from July 2020 to November 2020 were studied for their clinical findings. The fatal cases were subjected to autopsy and findings noted.Men were most commonly involved. All of the patients had self-harm intent while consuming. The most common presenting symptoms were difficulty in swallowing, Respiratory system was most commonly affected. The cause of death was attributed to respiratory and multi-organ failure.Paraquat is widely marketed for its efficacy and low environmental toxicity. Lack of a specific antidote increases the fatality. The most common cause of death is respiratory failure. Paraquat causes renal failure by causing hypovolemia, circulatory failure, septicemia, and direct toxicity. The mainstay of treatment is supportive though the use of immune-suppressants has shown some positive results.