[Failure of a cyclophosphamide-dexamethasone combination in paraquat poisoning]

A 37-year-old female deliberately ingested a 20% solution of paraquat in water. One hour later gastric lavage was carried out and bentonite was administered. Five hours later cyclophosphamide (5 mg/kg/day) and dexamethasone (24 mg/day) were started and a continuous intestinal lavage was carried out; four hours later, hemodialysis was begun. After 36 hours, features of renal and respiratory failure developed, with a rapid progress to respiratory distress. The patient died 94 hours after the ingestion of the poison. Despite early therapy with dexamethasone and cyclophosphamide, this patient's evolution does not support the presumed effectiveness of this drug association for paraquat poisoning.