TY  - JOUR
PY  - 2010//
TI  - Failed rescue therapy with rapamycin after paraquat intoxication
JO  - Clinical toxicology (Philadelphia, Pa.)
A1  - Lorenzen, Johan Matthes
A1  - Schonenberger, Eva
A1  - Hafer, Carsten
A1  - Hoeper, Marius
A1  - Kielstein, Jan T.
SP  - 84
EP  - 86
VL  - 48
IS  - 1
N2  - INTRODUCTION: Ingestion of large quantities of paraquat leads to irreversible, often fatal pulmonary fibrosis. Case presentation. A 50-year-old man (body weight of 78.6 kg) ingested 500 mL Gramoxone containing 200 g/L of paraquat in a suicide attempt. The patient did not seek medical attention until 15 h after ingestion. Initial treatment consisted of the administration of intravenous methylprednisolone, 250 mg once daily. Seventy-two hours after ingestion the patient was transferred to our tertiary care center. Paraquat concentration was 0.2 mg/L in the serum and urinary concentration was 4.42 mg/L. Antioxidative therapy including the administration of acetylcysteine and an anti-inflammatory therapy employing methylprednisolone (1 g/day) was started. Extended daily dialysis was initiated. As the high plasma concentration of paraquat indicated a 100% predicted mortality, we expanded treatment strategies by using the antiproliferative agent rapamycin. A dose of 8 mg/day was started 72 h after the intoxication. Maximum rapamycin concentrations amounted to 12.9 microg/L. Despite these efforts, the patient died on day 18 after intoxication from respiratory failure caused by severe pulmonary fibrosis.  CONCLUSION: Despite theoretical considerations suggesting the use of rapamycin in paraquat poisoning, the substance failed to halt the progression of pulmonary fibrosis in this case.<p /> <p>Language: en</p>
LA  - en
SN  - 1556-3650
UR  - http://dx.doi.org/10.3109/15563650903376089
ID  - ref1
ER  -