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Paraquat Toxicity and Lipid Peroxidation

Ronald D. Fairshter, MD
Arch Intern Med. 1981;141(9):1121-1123. doi:10.1001/archinte.1981.00340090017005.
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Paraquat (1,1′-dimethyl-4,4′-dipyridilium dichloride) is a commonly used, effective herbicide. When accidentally or intentionally ingested, paraquat is a multisystem poison capable of causing toxicity to the lungs, kidney, liver, brain, heart, and muscle.1,2 The compound is also corrosive to the mouth and skin1,2; furthermore, percutaneous absorption of paraquat can result in systemic toxicity.3 Without appropriate treatment, the mortality after ingestion of concentrates of paraquat (29.1% cationic solution) has ranged from 87% to 100%.4 Injection of as little as 1 mL subcutaneously has been fatal.5

Although paraquat damages many tissues, important clinical toxicity usually involves the lungs and kidneys.1,2 Renal failure is common after paraquat ingestion and has been a cause of fatalities. However, this renal failure is reversible and can be managed by conventional means. The major respiratory complications of paraquat poisoning are pulmonary edema and fibrosis.1,2 Pulmonary edema usually appears within the first few days after ingestion; pulmonary fibrosis ordinarily


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