DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20164194

A prospective study on clinical profile and incidence of acute kidney injury due to hair dye poisoning

P. Ramulu, P. Amruth Rao, Kanthi Swaroop K., Paul Marx K., Ch. Venkata Ramana Devi

Abstract


Background: Globally suicides are mounting at an alarming rate over the last few decades thus claiming the most productive age group of the society. Developing country like India is no exception to this needless increasing toll.

Methods: This study was a prospective observational study with 31 patients recruited at Osmania General Hospital between November 2011 – October 2013. Patients of alleged hair dye ingestion admitted in MICU were taken up for study after the exclusion criteria were ruled out. Informed consent was obtained from every patient or patient’s relatives. All routine laboratory investigations were done basing on standard clinical procedures and protocols and patient related clinical information were recorded on the prepared proforma from the time of hospital admission till discharge or death. The presence of AKI was defined and graded as per the RIFLE criteria.

Results: The present work examines 31 cases of suicidal ingestion of hair dye, out of which males were 6 (19.35%) and females were 25 (80.64%). It was observed that the tendency to commit suicide was more in the age group 21 -30 years with males (30%) and females (70%). 19% of total patients who ingested more than 50 ml of dye had developed Acute Kidney injury requiring hemodialysis. Upon treatment about 58% of patients were discharged from hospital in good general health condition, Four patients expired due to respiratory complications with pneumonia, ARDS, sepsis and ARF.

Conclusions: So in current scenario of emerging hair dye poisoning, it is imperative for a timely intervention by reducing the time of admission in hospital and also early management by clinicians is the need of an hour.


Keywords


Acute renal failure, Hair dye poisoning, Rhabdomyolysis

Full Text:

PDF

References


Corbett JF. Hair Colorants: Chemistry and Toxicology; Micelle Press: Dorset, U.K. JSCW. 1998.

Thompson RH. Naturally Occurring Quinones. Academic Press: New York. 1957.

Boldoc C, Shapiro J. Hair care products: Waving, straightening, conditioning and coloring. ClinDermatol. 2001;19:431-6.

Corbett JF, Menkert J. Hair colouring. Cutis. 1973;12:190-3.

Hansen J, Mollgaard B, Avnstorp C, Menne T. Paraben contact allergy: Patch testing and invitro absorption/metabolism. Am J Contact Dermat. 1993;4:78-86.

Schnuch A, Geier J, Uter W, Frosch PJ, Lehmacher W, Aberer W, et al. National rates and regional differences in sensitization to allergens of standard series. Contact Dermatitis. 1997;37:200-9.

Sax NJ. General chemicals. In: Dangerous Properties of Industrial Materials. New York: Reinhold. 1984;6:2148.

Zapolanski T, Jacob SE Para-Phenylenediamine. Systemic intoxication with PPD commonly occur via the oral and trans-dermal routes. Dermatitis. 2008;19:20-2.

Lava NS, Dollar Hair dye induced rhabdomyolysis. J Electroencephalogr Clin Neurophysiol. 1996;l98:18.

Saito K, Murai T, Yabe K, Hare M. Rhabdomyolysis due to paraphenylenediamine (hair dye) - report of an autopsy case. Nihon Hiogaku. 1990;44:469-74.

Anugrah C, Anisa B, Anand Z. Hair dye poisoning- An emerging problem in the tropics: An experience from a tertiary care hospital in South India. Trop Doct. 2010;40:100-03.

Anuradha S, Arora S, Mehrota S, Arora A, Kar P. Acute renal failure following paraphenylenediamine poisoning: A case report and review. Ren Fail. 2004;26:329-32.

Ram R, Swarnalatha G, Prasad N, Dakshinamurty KV Para phenylenediamine ingestion: An uncommon cause of acute renal failure. J Postgrad Med. 2007;53:181-82.

Sampath Kumar K, Sooraj YS, Mahaldar AR, Muthiah R. Rhabdomyolysis due to hair dye poisoning: An emerging threat. Indian J Crit Care Med. 2007;1:212-14.

Chrispal A, Begum A, Zachariah A. Hair dye poisoning – an emerging problem in the tropics: an experience from a tertiary care hospital in south India. Trop Doct. 2010;40:100-03.

Ostermann M, Chang R WS. Acute kidney injury in the intensive care unit according to RIFLE. Crit Care Med. 2007;35(8);1837-43.

Filali A, Semlali I, Ottaviano V, Soulyamani R, Furnari C, Corradini D. A retrospective study of acute systemic poisoning of paraphenylenediamine (occidental takawt) in Morocco. Afr J Trad CAM. 2006;3:142-9.

Suliman SM, Fadlalla M, Nasr ME, Beliela MH, Fesseha S, Babiker M et al. Poisoning with hair dye containing Paraphenylenediamine: Ten years’ experience. Saudi J Kidney Dis Transpl. 1995;6;286-9.

Yadavendrareddy KB, Chandrababu, Venkatasubbiah. A study of vasmol poisoning. Abstract of free paper presentation in proceedings of annual conference of association of physicians of India from Jan 29, 2009 to Feb 1, 2009 at Greater Noida, India.

Jain PK, Agarwal N, Kumar P, Sengar NS, Agarwal N, Akhtar A. Hair Dye poisoning in Bundelkhand region (Prospective analysis of hair dye poisoning cases presented in Department of Medicine, MLB Medical College, Jhansi). JAPI. 2011;59:415-9.

Singla S, Sanjeev M, Lal AK, Gupta P, Agarwal AK. Paraphenylenediamine poisoning. J Ind Ac Of Clin Med. 2005;6(3):236-8.

Sharma A, Mahi S, Sharma N, Suryanarayana BS, Bhalla A, Suri V, et al. Intravascular hemolysis and acute renal failure following hair dye poisoning. In the proceedings of the 7th International Congress of the Asia-Pacific Association of Medical Toxicology at Chandigarh, India.

Kallel H, Chelly H. Dammak H, Bahloul M, Ksibi H, Hamida CB. Clinical manifestations of systemic PPD intoxication. J Nephrol. 2005;18(3):308-11.

Sachin S, Nagarik AP, Manjunath D, Gopal Krishnan A, Anuradha. Systemic toxicity of paraphenylenediamine. Indian J Med Sci. 2009;63(4):164-6.

ManishaSahay, Vani R, Valli S. Hair Dye Ingestion – An uncommon cause of Acute Kidney Injury. J Assoc Physicians India. 2009;57:35-8.

Huerta-Alardin AL, Valon J, Marik PE. Bench-to-bedside review: Rhabdomyolysis-An overview for clinicians. Crit Care. 2005;9:158-69.