Paraphenylene diamine poisoning: Our experience at PMC Hospital Nawabshah

Objective: The aim of this descriptive, case series study was to study demographics, clinical features and outcome of paraphenylene diamine (PPD) (commonly known by local people as 'kala pathar') poisoning admitted to our intensive care unit (ICU) from June 2009 and May 2012. Methodology: All cases of PPD poisoning admitted to ICU of the Peoples Medical College Hospital, Nawabshah, between June 2009 and May 2012 were included in this study. Demographic features, clinical features and outcome of patients were recorded. Results: A total of 16 poisoning cases were admitted to the ICU. The mean age was 25.87 +/- 5.59 years; a majority of the patients were young females (21-30 years) and belonged to a low socioeconomic class. The main cause was intentional suicidal ingestion. Cervicofacial edema, throat pain, dysphagia, dysphonia, and stridor were the earliest clinical findings. Rhabdomyolysis, hepatitis and acute renal failure dominated the clinical picture during the later course of poisoning. Active pharmacological intervention, elective tracheostomy and assisted ventilation were the therapeutic measures required for survival. A high mortality rate (37.5%) was observed in the study. Conclusion: Paraphenylene diamine (PPD) poisoning is associated with high morbidity & mortality.