Journal of Clinical Pediatrics >
Clinical analysis of eight cases with diquat poisoning in children and literature review
Received date: 2024-08-27
Accepted date: 2024-11-12
Online published: 2025-06-01
Objective To enhance the understanding of the clinical characteristics of diquat poisoning in children. Methods A retrospective analysis was conducted on the clinical data of eight pediatric patients diagnosed with diquat poisoning at our hospital. "Diquat" and "diquat poisoning" were used as keywords to search in CNKI, Wanfang and PubMed database from inception to April 2024. Previous case reports were reviewed and summarized. Results Among the eight cases, there were two males and six females aged 3-14 years who ingested 1-180 g of poison. Six cases exhibited gastrointestinal symptoms, four cases showed varying degrees of lung injury, and two cases presented with severe neurological symptoms. The patients received gastric lavage, rehydration, and blood purification therapy. Ultimately, six patients survived, while two (25%) died. Additionally, sixteen cases from nine published papers were analyzed, revealing that nine cases developed different degrees of lung injury. All twelve cases reported in China survived, whereas four cases reported internationally and the two fatalities in this study exhibited earlier-onset severe neurological symptoms. Conclusion Lung injury caused by mild-to-moderate diquat poisoning in children is reversible, but severe diquat poisoning can progress rapidly and lead to multiple organ failure. Patients presenting with early severe neurological symptoms generally have a poor prognosis.
Key words： diquat; diquat poisoning; child; literature review
WANG Xiao , LI Quanheng , ZHAO Zhai , ZHAO Pei , HAO Pengli , LIANG Xingsi , GENG Wenjin . Clinical analysis of eight cases with diquat poisoning in children and literature review[J]. Journal of Clinical Pediatrics, 2025 , 43(6) : 452 -457 . DOI: 10.12372/jcp.2025.24e0885
| [1] | Powell D, Pond SM, Allen TB, et al. Hemoperfusion in a child who ingested diquat and died from pontine infarction and hemorrhage[J]. J Toxicol Clin Toxicol, 1983, 20(5): 405-420. |
| [2] | Ness-Cochinwala M, Proa?o JS, Bernstein JN, et al. A case of a lethal diquat ingestion in a toddler[J]. J Emerg Med, 2022, 62(2): e16-e19. |
| [3] | Gummin DD, Mowry JB, Beuhler MC, et al. 2020 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 38th annual report[J]. Clin Toxicol (Phila), 2021, 59(12): 1282-1501. |
| [4] | 杨洵. 急性敌草快中毒3例救治体会[J]. 饮食保健, 2018, 5(4):76-77. |
| Yang X. Treatment experience of 3 cases of acute diquat poisoning[J]. Yinshi Baojian, 2018, 5(4): 76-77. | |
| [5] | 张华忠, 孙昊, 陈旭锋, 等. 敌草快中毒致急性肾损伤肾活检2例报道[J]. 中华急诊医学杂志, 2022, 31(8): 1121-1123. |
| Zhang HZ, Sun H, Chen XF, et al. Two case reports of renal biopsy of acute kidney injury caused by diquat poisoning[J]. Zhonghua Jizhen Yixue Zazhi, 2022, 31(8): 1121-1123. | |
| [6] | 王君君, 仝帅, 张唐娟, 等. 敌草快相关中毒性脑病7例报道[J]. 中华急诊医学杂志, 2022, 31(12): 1648-1653. |
| Wang JJ, Tong S, Zhang TJ, et al. Seven cases of toxic encephalopathy associated with diquat poisoning[J]. Zhonghua Jizhen Yixue Zazhi, 2022, 31(12): 1648-1653. | |
| [7] | 陈赫赫, 王艳, 董卓亚, 等. 儿童急性敌草快中毒诊治三例[J]. 中华重症医学电子杂志, 2021, 7(2): 180-184. |
| Chen HH, Wang Y, Dong ZY, et al. Clinical analysis and treatment of 3 children with acute diquat poisoning[J]. Zhonghua Zhongzheng Yixue Zazhi, 2021, 7(2): 180-184. | |
| [8] | 覃烁, 王晓敏, 李晓卿. 儿童敌草快中毒2例报道[J]. 中国工业医学杂志, 2023, 36(5): 412-414. |
| Tan S, Wang XM, Li XQ. Reports of two cases of diquat poisoning in children[J]. Zhongguo Gongye Yixue Zazhi, 2023, 36(5): 412-414. | |
| [9] | 段永春, 陈安宝, 李芳, 等. 强化血液净化救治急性敌草快中毒15例[J]. 中华急诊医学杂志, 2024, 33(3): 302-306. |
| Duan YC, Chen AB, Li F, et al. Strengthened hemoperfusion treated 15 cases of acute diquat poisoning[J]. Zhonghua Jizhen Yixue Zazhi, 2024, 33(3): 302-306. | |
| [10] | Chen AB, Li F, Di EM, et al. Influence of strengthened hemoperfusion combined with continuous venovenous hemofiltration on prognosis of patients with acute paraquat poisoning: SHP+CVVH improve prognosis of acute PQ patients[J]. BMC Pharmacol Toxicol, 2020, 21(1): 49. |
| [11] | 黄国亮, 陈冰冰, 陈黎明. 血液灌流联合连续肾脏替代治疗救治敌草快中毒的疗效探讨[J]. 中外医疗 2023, 42(5): 33-37. |
| Huang GL, Chen BB, Chen LM, et al. Discussion on the curative effect of hemoperfusion combined with con-tinuous renal replacement therapy in the treatment of diquat poisoning[J]. Zhongwai Yiliao, 2023, 42(5), 33-37. | |
| [12] | Yu G, Jian T, Cui S, et al. Acute diquat poisoning resulting in toxic encephalopathy: a report of three cases[J]. Clin Toxicol (Phila), 2022, 60(5): 647-650. |
| [13] | 急性DQ中毒诊断与治疗专家共识组. 急性敌草快中毒诊断与治疗专家共识[J]. 中华急诊医学杂志, 2020, 29(10): 1282-1289. |
| Experts consensus group on the diagnosis and treatment of acute DQ poisoning. Experts consensus on the diagnosis and treatment of acute diquat poisoning[J]. Zhonghua Jizhen Yixue Zazhi, 2020, 29(10): 1282-1289. | |
| [14] | Huang Y, Zhang R, Meng M, et al. High-dose diquat poisoning: a case report[J]. J Int Med Res, 2021, 49(6): 1-10. |
| [15] | 刘露, 吴霜, 蔡舒, 等. 急性敌草快中毒的胸部CT表现[J]. 现代预防医学, 2018, 45(16): 3048-3051. |
| Liu L, Wu S, Cai S, et al. Chest CT imaging manifestation of acute diquat poisoning[J]. Xiandai Yufang Yixue, 2018, 45(16): 3048-3051. | |
| [16] | Manabe J, Ogata T. Lung fibrosis induced by diquat after intratracheal administration[J]. Arch Toxicol, 1987, 60(6): 427-431. |
| [17] | 孙艺青, 苑霖, 高恒波, 等. Wistar大鼠急性敌草快中毒模型的建立与评估[J]. 中华劳动卫生职业病杂志, 2019, 37(5): 342-346. |
| Sun YQ, Yuan L, Gao HB, et al. Establishment and evaluation of acute diquat poisoning model in Wistar rats[J]. Zhonghua Laodongweisheng Zhiyebing Zazhi, 2019, 37(5): 342-346. | |
| [18] | Fussell KC, Udasin RG, Gray JP, et al. Redox cycling and increased o+ygen utilization contribute to diquat-induced oxidative stress and cytotoxicity in Chinese hamster ovary cells overexpressing NADPH-cytochrome P450 reductase[J]. Free Radic Biol Med, 2011, 50(7): 874-882. |
| [19] | 胡惠, 杜宇. 急性敌草快中毒患者的血浆代谢组学特征初探[J]. 四川大学学报(医学版), 2023, 54(6): 1219-1226. |
| Hu H, Du Y. A preliminary study on the plasma metabolomic profiles of patients suffering from acute diquat poisoning[J]. Sichuan Daxue Xuebao, 2023, 54(6): 1219-1226. | |
| [20] | 张晓颖, 李国强, 刘斌. DQ中毒致神经系统损害的研究进展[J]. 中华劳动卫生职业病杂志, 2022, 40(8): 636-640. |
| Zhang XY, Li GQ, Liu B. The research progress of nervous system damage caused by diquat poisoning[J]. Zhonghua Laodong Weisheng Zhiyebing Zazhi, 2022, 40(8): 636-640. | |
| [21] | 孟娜, 孙艺青, 董艳玲, 等. 敌草快的人体毒代动力学及血液灌流疗效评估[J]. 中华急诊医学杂志, 2020, 29(11): 1403-1410. |
| Meng N, Sun YQ, Dong YL, et al. Toxicokinetic and the therapeutic effect of hemoperfusion in patients with acute diquat poisoning[J]. Zhonghua Jizhen Yixue Zazhi, 2020, 29(11): 1403-1410. |
/
| 〈 |
|
〉 |
