Kına Alımı Sonrası Parafenilendiamine Bağlı İntoksikasyon

Year 2021, , 31 - 33, 18.03.2021

Fatih Öner , Ümran Öner

https://doi.org/10.33706/jemcr.832026

Abstract

Giriş: Kına, doğu kültürlerinde saç boyası ve dövme olarak uzun yıllardır kullanılmaktadır. Parafenilendiamin (PPD), kınaya eklenen bir çeşit aromatik amindir. PPD eklendiğinde oluşan formülasyonun oldukça toksik olduğu bilinmektedir.
Olgu sunumu: Burada intihar amaçlı kına alımı sonrası PPD'ye bağlı yaygın anjiyoödem, rabdomiyoliz ve akut böbrek yetmezliği ile acil servise başvuran 16 yaşında bir kadın hasta sunuldu. Hastaya şiddetli solunum sıkıntısı nedeniyle acil trakeotomi yapıldı ve hasta yoğun bakımda mekanik ventilatöre bağlanarak takip edildi.
Sonuç: PPD intoksikasyonu hayatı tehdit eden bir durumdur ve PPD intoksikasyonu için spesifik bir antidot yoktur. Hayat kurtarıcı olduğu için hastaya erken müdahale şarttır.

Keywords

Akut böbrek yetmezliği, Anjionörotik ödem, Kına, Parafenilendiamin, Rabdomiyoliz, Trakeotomi

Intoxication Caused by Paraphenylenediamine After Henna Ingestion

Abstract

Introduction: Henna, has been applied in eastern cultures for many years, as a hair dye and tattoo. Paraphenylenediamine (PPD) is a kind of aromatic amine added to henna. The formulation formed when PPD added known to be highly toxic.
Case report: Here, a 16-year-old female patient admitted to an emergency clinic with severe angioedema, rhabdomyolysis, and acute renal failure caused by PPD after henna ingestion for suicidal purposes, was presented. An emergency tracheotomy was performed to the patient because of severe respiratory distress, and the patient was followed up by connecting to the mechanical ventilator in intensive care.
Conclusion: PPD poisoning is a life-threatening condition, and there is no specific antidote for PPD intoxication. Early intervention to the patient is essential because it is life-saving.

Keywords

Acute renal failure, Angioneurotic edema, Henna dye, Para-phenylenediamine, Rhabdomyolysis, Tracheotomy

References

• 1. Yagi, H, el Hind AM, Khalil SI. Acute poisoning from hair dye. East Afr Med J 1991; 68(6): 404-11.
• 2. Chugh KS, Malik GH, Singhal PC. Acute renal failure following paraphenylenediamine [Hair dye] poisoning: report of two cases. J Med 1982; 13(1-2): 131-7. https://doi.org/10.1081/JDI-200026722
• 3. Jain PK, Agarwal N, Sharma Ak, Akhtar A. Prospective study of ingestional hair dye poisoning in Northern India (Prohina). J Clin Med Res 2011; 3(1): 9-19.
• 4. Nott HW. Systemic poisoning by hair dye. Br Med J. 1924; 1(3297): 421-2.
• 5. Rund D, Schaap T, Da’as N, Yehuda B, Kalish J. Plasma exchange as treatment for lawsone (henna) intoxication. J Clin Apher 2007; 22(4): 243-5. https://doi.org/10.1002/jca.20128.
• 6. Kallel H, Chelly H, Dammak H, Bahloul M, Ksibi H, Chokri B.H, et al. Clinical manifestations of systemic paraphenylenediamine intoxication. J Nephrol 2005; 18(3): 308.
• 7. Meisser SS, Altunbulakli C, Bandier J, Opstrup M.S, Castro-Giner F, Akdis M, et al. Skin barrier damage after exposure to paraphenylenediamine. J Allergy Clin Immunol 2020; 145(2): 619-31. https://doi.org/10.1016/j.jaci.2019.11.023
• 8. Kök AN, Ertekin V, Bilge Y, Işık AF. An unusual cause of suicide: henna (Lawsonia inermis Linn.). J Emerg Med 2005; 29(3): 343–4. https://doi.org/10.1016/j.jemermed.2005.06.003
• 9. Bezgin S.Ü, Çakabay T, Koçyiğit M, İpek H.D, Giran Örtekin S, Gemici H. Pediatric tracheotomy: indications and outcomes. KBB ve BBC Dergisi 2020; 28(2): 124-30. https://doi.org/10.24179/kbbbbc.2020-74159
• 10. Kaballo BG, Khogali MS, Khalifa EH, Khaiii EA, Ei-Hassan AM, Abu-Aisha H. Patterns of "severe acute renal failure" in a referral center in Sudan: excluding intensive care and major surgery patients. Saudi J Kidney Dis Transpl 2007; 18(2): 220-5.