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Acute kidney injury: A rare cause
Satish Mendonca1, Satish Barki, Mayank Mishra
1Department of Nephrology, Armed Forces Medical College and Command Hospital Southern Command, Pune, India.
Summary
Hair dye ingestion containing paraphenylene diamine (PPD) caused severe rhabdomyolysis and acute kidney injury (AKI). PPD may have long-term effects, causing persistent paralysis and hindering kidney recovery, necessitating prompt urine alkalinization and considering hemoperfusion.
Area of Science:
- Toxicology
- Nephrology
- Neurology
Background:
- Paraphenylene diamine (PPD) is a common chemical in hair dyes.
- Deliberate self-harm involving PPD ingestion can lead to severe systemic toxicity.
Observation:
- A young woman ingested hair dye containing PPD, resulting in angio-neurotic edema requiring ventilation.
- She developed rhabdomyolysis, acute kidney injury (AKI), and persistent flaccid quadriparesis.
Findings:
- Renal biopsy revealed acute tubular necrosis with myoglobin casts 10 weeks post-ingestion.
- Findings suggest PPD causes long-term myoglobinuria, leading to persistent paralysis and impaired kidney function recovery.
Implications:
- Prompt urine alkalinization is crucial for preventing AKI in PPD poisoning.
- Hemoperfusion may be beneficial for removing the non-dialyzable PPD toxin and mitigating long-term effects.
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