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Clinical Features and Investigation of Hair Dye Poisoning

In this article, we will discuss the Clinical Features and Investigation of Hair Dye Poisoning. So, let’s get started.

Clinical Features

The poisoning is mainly ingestional for suicidal intent. Symptoms appear within few hours. The main symptoms include angioedema of face, neck, larynx leading to acute breathing problem. There is chocolate brown colored urine. There is a toxic effect of PPD. This is followed by bone pain and tender muscles due to rhabdomyolysis and acute renal failure which may set in due to hypovolemia and intravascular hemolysis or by direct nephrotoxicity of PPD and may even lead to death. Other effects of PPD are liver failure, altered sensorium, convulsions, GI symptoms etc.

The other component resorcinol is corrosive, produces methaemoglobinemia and renal toxicity. The sodium EDTA can produce hypocalcemia and tetany.

Investigation

Investigation include complete hemogram, blood urea, serum creatinine, electrolytes (Na+, K+, Mg++), CPK, ECG and blood methaemoglobin and myoglobinuria for rhabdomyolysis. LFTs must be done.

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Clinical Features of Corrosive Acid Poisoning

In this article, we will discuss the Clinical Features of Corrosive Acid Poisoning. So, let’s get started.

Clinical Features

The clinical manifestations depend on the concentration and quantity of acid consumed. The symptoms and signs given below:

A. Ingestional Poisoning

1. Mouth and Oropharynx

Symptoms

  • Pain in mouth, throat and drooling of saliva
  • Difficulty in speech (hoarseness or dysphonia) due to edema of glottis
  • Choking and stridor
  • Constant cough, dyspnea

Signs

  • Skin and oropharyngeal burns, ulcers, edema, necrosis, discoloration of mouth
  • Deep mucosal burns may produce anesthesia
  • Drooling of saliva over lips produce charring of skin over angles of mouth, chin and chest
  • In severe cases, the tongue is shapeless, a pulpy mass
  • Teeth may become chalky white and loose shine in severe poisoning (corrosion of teeth)

2. Esophagus

Symptoms

  • Painful swallowing, retrosternal pain, neck pain/tenderness
  • Haematemesis (vomiting with altered blood and mucus)

Signs

  • Esophageal burns and ulcers. The mucosa is red and swollen

3. Stomach

Symptoms

  • Epigastric pain, burning and tenderness
  • Vomiting. It is strongly acidic, will cause effervescence on coming in contact with earth and will stain clothes

Signs

  • Gastric burns

4. Respiratory tract (due to aspiration)

Symptoms

  • Cough and dyspnea
  • Hoarseness and dysphonia
  • Labored breathing

Signs

  • Tracheitis and pneumonia
  • Pleural effusion may develop

Inhalation poisoning (inhalation of gases i.e. chlorine, fluorine, bromine, iodine, etc)

Symptoms

  • Upper respiratory obstruction, cough, dyspnea

Signs

  • Non-cardiogenic pulmonary edema (rales, crackles)

Definition of Epidemic Dropsy

In this article, we will discuss the Definition of Epidemic Dropsy. So, let’s get started.

Definition

It is defined as edema occurring in epidemic form due to consumption of contaminated edible oil (mustard oil) with argemone oil- a toxic ingredient.

It is known to occur in epidemics in India, and recent epidemic of this poisoning has been reported from Delhi and the adjoining areas in 1990.

Mode of Poisoning

It is ingestional. Mustard oil is used as a cooking oil in certain parts of India especially West Bengal from where first epidemic broke. Mustard, sometimes gets contaminated with Mexican poppy (Argemone mexicana) seeds (in India, it is known as Sialkanta, Daurdy, Satyanshi, Brahmdandi or Pila Datura). Consumption of this contaminated oil leads to poisoning called epidemic dropsy. The toxic ingredients of argemone oil are sanguinarine and disanguinarine.

Clinical Features of Opiates Poisoning

In this article, we will discuss the Clinical Features of Opiates Poisoning. So, let’s get started.

Clinical Features

High doses of opiates (oral or I.V.) can result in overdosage or poisoning. This occurs in 50% opiates dependent persons especially with the use of more potent drugs such as fentanyl. Toxic symptoms appear when it is consumed 20 times the required dose. The typical symptoms of intoxication syndrome occur immediately after I.V. overdose. The signs and symptoms include euphoria, depressed respiration (slow and shallow breathing), constriction of pupils (pupils get dilated if brain damage occurs), hypotension, bradycardia, hypothermia, and stupor or coma. If not treated immediately then respiratory depression, pulmonary edema, cardiorespiratory arrest, and death can occur.

Methadone has been associated with prolonged QT interval and torsades de pointes. Tramadol, propoxyphene, dextromethorphan and meperidine can cause seizures. The duration of effect of opiate varies from few hours (heroine) to days (methadone).

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