[A case report of acute hexazinone poisoning resulting in multiple organ dysfunction syndrome]

Hexazinone is a low-toxicity forest herbicide; however, high-dose oral administration can still lead to severe systemic poisoning. This article reports a case of a patient admitted to the Emergency Department of Liaocheng People's Hospital approximately 28 hours after ingesting 200 ml of a 25% hexazinone aqueous solution. The plasma hexazinone concentration was 29.3 μg/mL; at admission, the patient exhibited acute kidney injury (creatinine: 425.9 μmol/L), acute liver injury (aspartate aminotransferase: 655 U/L), myocardial injury (myocardial troponin I: 0.16 ng/mL), rhabdomyolysis, and metabolic acidosis; the patient was diagnosed with severe acute hexazinone poisoning and multiple organ dysfunction syndrome. Following gastrointestinal lavage, hemoperfusion combined with continuous venovenous hemofiltration (CVVH+HP) for approximately 50 hours, along with comprehensive therapeutic measures including hepatoprotective and acid suppression therapies, all clinical parameters returned to normal, and the patient was discharged in full recovery. Currently, there is no specific antidote for hexazinone poisoning; early gastrointestinal decontamination and prompt initiation of CVVH+HP blood purification are critical for successful treatment.