BACKGROUND: Paraquat is a bipyridyl compound, and when ingested, concentrated paraquat can cause either rapid death from multisystem failure and cardiovascular shock or delayed death from progressive pulmonary fibrosis. Paraquat is poorly absorbed by inhalation, but when ingested orally, severe illness can occur. Death usually occurs within 2 days if more than 50mg/kg of paraquat is ingested. The most important prognostic indicator is the quantity of paraquat absorbed, as shown by the plasma paraquat concentration. However, in Korea, there are few, if any, institutes that can measure the plasma paraquat concentration, and the prognostic indication depends mostly on the description given by the patients and their families about the amount of paraquat ingested, which is often underestimated or overestimated. For these reasons, we tried to compare the plasma paraquat concentrations with amount of paraquat described by patients or their families. METHODS: We reviewed the medical records of 59 patients with acute paraquat poisoning from February 1998 through February 1999. The paraquat concentrations in plasma were measured at Presbyterian Medical Center by using high performance liquid chromatography. RESULTS: There was a striking discrepancy between the plasma paraquat concentration and the ingested amount described by the patients or their families. CONCLUSION: We recommend that the plasma paraquat concentration be measured in patients being treated for acute paraquat poisoning.
2,2'-Dipyridyl ; Academies and Institutes ; Chromatography, Liquid ; Humans ; Inhalation ; Korea ; Medical Records ; Paraquat* ; Plasma* ; Poisoning* ; Protestantism ; Pulmonary Fibrosis ; Shock ; Strikes, Employee

Paraquat is the most important bipyridyl herbicide, acting as a norselective herbicide with somewhat unique properties. The major acute local cutaneous side effects reslt from the caustic properties of paraquat, which produce local ulceration of the epithelial surface. Blistering of the skin and cracking and even loss of the fingernails have been reported. Its systemic taxic ties also include pulmonary fibrosis, cardiac failure, renal failure, and hepatotoxicity. We report a case of erytlema multiforme with transient heat-toxicity due to percutanious absorption of paraquat. A 31-year-old farmer was admitted to our de artment because of target-like bullous erythema on both thighs and buttocks following accidenta contact with paraquat. The histopathologic findings show d spongiesis, exocytosis, intercellular dema in the epidermis, degeneration of dermo-epidermal junction and inflammatory cell infiltrations in the dermis especially papillary and perivascular area.
2,2'-Dipyridyl ; Absorption ; Adult ; Blister ; Buttocks ; Dermis ; Epidermis ; Erythema Multiforme* ; Erythema* ; Exocytosis ; Heart Failure ; Humans ; Nails ; Paraquat ; Pulmonary Fibrosis ; Renal Insufficiency ; Skin ; Thigh ; Ulcer