Abstract
Hair dye ingestion is a rare cause of toxicity in Pakistan. Hair dyes contain paraphenylene-diamine (PPD) and a host of other chemicals that can cause rhabdomyolysis, laryngeal edema, severe metabolic acidosis and acute renal failure. Clinical outcomes rely on early recognition, prompt referral, and aggressive supportive treatment. Timely intervention has been shown to improve the outcome. There are many case reports of PPD poisoning in adults in which it was mainly used for deliberate self-harm purpose. However there is very little data regarding PPD poisoning in children. We report a case of a three year old boy who presented with severe respiratory distress and angioedema, who underwent emergent tracheostomy placement.
Highlights
Paraphenylenediamine (PPD) poisoning is amongst one of the emerging causes of poisoning in Asian countries
PPD is allergenic and tubulotoxic and causes angioneurotic edema and rhabdomyolysis, which lead to renal failure [1]
Common presenting features include development of edema of the face, neck, pharynx, tongue and larynx, sinus bradycardia, sinus tachycardia, hemodynamic instability and rhabdomyolysis followed by acute renal failure (ARF) as renal tubular necrosis occurs [2]
Summary
Paraphenylenediamine (PPD) poisoning is amongst one of the emerging causes of poisoning in Asian countries. It is a constituent of hair dye formulation marked with the name of ‘Kaala Pathar’ and available in market at a low cost. It comes in grains or crystals like form, is crushed, mixed with henna and used as hair dye for enhancing its color. PPD is allergenic and tubulotoxic and causes angioneurotic edema and rhabdomyolysis, which lead to renal failure [1]. Common presenting features include development of edema of the face, neck, pharynx, tongue and larynx, sinus bradycardia, sinus tachycardia, hemodynamic instability and rhabdomyolysis followed by acute renal failure (ARF) as renal tubular necrosis occurs [2]
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