Five autopsy cases of poisoning by the weed killer paraquat (Gramoxone) are presented.
Case 1. A 33-year-old female swallowed about 150 ml of Gramoxone. She died after 11 hours of intoxication.
Abnormal post-mortem findings were confined to the lungs, the kidneys and the adrenals. Histologically, the lungs showed congestion and edema; the kidneys showed tubular' degeneration and necrosis; and the adrenals showed cortical degeneration and necrosis.
Case 2. A 74-year-old male swallowed about 20 ml of Gramoxone. He died on the 4th day of ingestion of Gramoxone.
Histologically, the lungs were congestive and there were a moderate degree of hyperplasia of alveolar septa.
Alveolar spaces contained edematous fluid containing fibrin. Some skeletal muscle fibers were variable in size, and showed degenerative changes including vacuolization. The adrenal cortex was atrophic.
Case 3. A 44-year-old female swallowed about 20 ml of Gramoxone. She died on the 8th day of ingestion. The lungs were both congestive and edematous. Alveolar spaces contained edematous fluid with a trace amount of fibrin. The kidneys showed tubular degeneration. The liver showed a moderate degree of fatty changes in the central zones.
Acute oesophagitis and acute ulcerative change in the stomach were noticed.
Case 4. A 45-year-old male swallowed about 90 ml of Gramoxone. He died after 12 hours of intoxication. Histologically, the lungs were remarkably congestive and edematous. There were fatty changes in the central areas of the liver. Acute gastritis were noticed.
Case 5. A 32-year-old female swallowed about 15 ml of Gramoxone. She died on the 28th day of ingestion. At post-mortem examination, the lungs were solid and atelectatic. Histologically, the lungs showed generalized, severe degree of fibrosis together with desquamative changes of alveolar epithelium and PAS-positive hyaline menbrane formations. The liver showed a moderate degree of fatty changes in the central areas. The skeletal muscle fibers were variable in size showing a moderate degree of vacuolar and targetoid changes.
Various amounts of Paraquat were detected in the lungs, the livers, the kidneys and the muscles of case 1 and 4, in the fatty tissues and the brain of case 1 using formalin-fixed specimens.
Degenerative changes of skeletal muscle fibers presented in this report may be ascribed to the effect of Praquat in the light of the literature.