Acute diquat poisoning case with multiorgan failure and a literature review: A case report

Table 1 Laboratory investigations

Item	On admission	20 h post-admission
WBC count (4-10 × 109/L)	23.67	24.2
Urea (2.6-7.5 mmol/L)	5.4	5.7
Creatinine (57-97 μmol/L)	92	140.3
ALT (7-40 U/L)	11.7	2084.9
AST (13-35 U/L)	10.1	2633
Lac (0.5-1.7 mmol/L)	4.0	9.4
PTA (70%-130%)	115.1	18.9
INR (0.8-1.2)	0.89	3.63
Myoglobin (28-72 ng/mL)	77.47	9703
Creatine kinase (50-310 U/L)	604	> 22000

WBC: White blood cell count; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; PTA: Prothrombin activation; INR: International normalized ratio.

Table 2 Literature case summary

Case	Gender	Age	Dose (g)	Organ function damage	Measures of treatment	Prognosis
						Outcome	Duration
1[3]	Male	21	20	AKI, liver dysfunction, epilepsy, brain stem infarction, leukocytosis	Gastric lavage, HP + CVVH, MV, glucocorticoids	Death	96.0 h
2[3]	Female	26	10	AKI, liver dysfunction, epilepsy, mental and behavioral abnormalities, leukocytosis	Gastric lavage, HP + CVVH, glucocorticoids	Alive	-
3[4]	Female	24	60	AKI, liver dysfunction, epilepsy, rhabdomyolysis, leukocytosis, myocardial injury	Gastric lavage, HP + CVVH	Death	17.8 h
4[5]	Female	27	4	Gastrointestinal Symptoms	Gastric lavage, HP + CVVH	Alive	-
5[5]	Female	30	4	Gastrointestinal symptoms, leukocytosis	Gastric lavage, HP	Alive	-
6[5]	Female	68	10	AKI, liver dysfunction, toxic encephalopathy, leukocytosis, lung injury	Gastric lavage, HP	Death	Unknown
7[5]	Male	24	10	AKI, leukocytosis, myocardial Injury	Gastric lavage, HP + CVVH	Alive	-
8[5]	Male	33	20	AKI, liver dysfunction, leukocytosis, lung injury, myocardial injury	Gastric lavage, HP + CVVH	Death	Unknown
9[5]	Male	62	40	AKI, toxic encephalopathy, lung injury, myocardial injury, leukocytosis	Gastric lavage, HP + CVVH	Death	Unknown
10[6]	Female	32	8	AKI, liver dysfunction, epilepsy, leukocytosis, shock	Gastric lavage, HP + CVVH, MV, glucocorticoids	Death	68.5 h
11[7]	Male	29	50	AKI, liver dysfunction, leukocytosis	Gastric lavage, HP + CVVH, MV, glucocorticoids	Death	480.0 h
12[8]	Female	41	40	AKI, liver dysfunction, leukocytosis, rhabdomyolysis	Gastric lavage, HP, glucocorticoids	Death	46.0 h
13[9]	Male	17	40	AKI, liver dysfunction, paralytic ileus, coma, myocardial injury, leukocytosis, rhabdomyolysis, shock	Gastric lavage, HP + CVVH, MV, glucocorticoids	Death	40.5 h
14[9]	Female	18	40	AKI, liver dysfunction, paralytic ileus, coma, leukocytosis, rhabdomyolysis, arrhythmia	Gastric lavage, HP + CVVH, glucocorticoids	Death	29.0 h
15[10]	Male	21	20	AKI, liver dysfunction, Pontine demyelination, Lung injury, leukocytosis	Gastric lavage, HP + CVVH, glucocorticoids	Death	360.0 h
16[11]	Female	36	6	AKI, liver dysfunction, leukocytosis, lung injury, rhabdomyolysis	Gastric lavage, HP + CVVH, glucocorticoids	Alive	-
17[12]	Male	30	32	AKI, liver dysfunction, respiratory failure, leukocytosis	Gastric lavage, HP + CVVH, MV	Death	312.0 h
18[13]	Male	20	32	AKI, liver dysfunction, central pontine myelinolysis, leukocytosis	Gastric lavage, HP + CVVH, MV, glucocorticoids	Alive	-

AKI: Acute kidney injury; MV: Mechanical ventilation; HP: Hemoperfusion; CVVH: Continuous veno-venous hemofiltration.