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High-Dose Cyclophosphamide and Dexamethasone in Paraquat Poisoning: A Prospective Study

Department of Internal Medicine, Akademisch Ziekenhuis, Paramaribo, Suriname, Faculty of Medicine, Anton De Kom University, Paramaribo, Suriname

S. Benimadho

Faculty of Medicine, Anton De Kom University, Paramaribo, Suriname

I. Lie Kiauw

Department of Internal Medicine, Akademisch Ziekenhuis, Paramaribo, Suriname

J. Wisse

Department of Internal Medicine, Akademisch Ziekenhuis, Paramaribo, Suriname

H. Chee

Department of Internal Medicine, Akademisch Ziekenhuis, Paramaribo, Suriname, Faculty of Medicine, Anton De Kom University, Paramaribo, Suriname

Between March 1986 and March 1988, 47 consecutive patients, whose paraquat intoxication was confirmed by urine testing, were enrolled in a prospective study on the treatment of paraquat poisoning. Fourteen received a standard treatment regimen consisting of fluid replacement and oral absorbents, and 33 received high-dose cyclophosphamide and dexamethasone, in addition to standard therapy.

The case fatality rate in both treatment groups (63 and 61%) was similar. In addition, all 26 patients whose paraquat serum concentrations were measured and who had a probability of survival of less than 65% according the survival curve of Hart et al. died, regardless of therapy. These included four in the cyclophosphamide/dexamethasone group and two in the standard treatment group who had prior survival probabilities between 50 and 65%. This indicated that the cut-off curve relating mortality and paraquat serum concentrations was similar in both treatment groups.

High-dose cyclophosphamide/dexamethasone treatment is unlikely to improve the prognosis of paraquat poisoning.

Human & Experimental Toxicology, Vol. 11, No. 2, 129-134 (1992)
DOI: 10.1177/096032719201100212


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