2/11/23, 2:12 PM Lethal diquat poisoning manifesting as central pontine myelinolysis and acute kidney injury: A case report

idney injury: A case report and literature review - PubMed

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Review J Int Med Res. 2020 Jul;48(7):300060520943824. doi: 10.1177/0300060520943824.

Lethal diquat poisoning manifesting as central

pontine myelinolysis and acute kidney injury: A case
report and literature review
Jihong Xing  1 , Zhe Chu  1 , Dongfeng Han  1 , Xiaoming Jiang  1 , Xiuxian Zang  1 , Yajie Liu  1 , 
Song Gao  1 , Lichao Sun  1

Affiliations
PMID: 32734801 PMCID: PMC7401049 DOI: 10.1177/0300060520943824
Free PMC article

Abstract
Diquat is a nonselective herbicide that is used as a contact and preharvest desiccant to control
terrestrial and aquatic vegetation. Increasing numbers of cases of diquat poisoning have recently
been reported. Organs commonly affected by diquat poisoning include the kidney, liver, and lung.
Neurological involvement of diquat poisoning is relatively rare. A 21-year-old man ingested 100 mL of
diquat (20 g/100 mL) 5 hours before admission. Fifteen minutes after ingestion, he developed nausea
and vomiting. The patient was sent to the emergency intensive care unit, and gastric lavage was

https://pubmed.ncbi.nlm.nih.gov/32734801/ 1/3
2/11/23, 2:12 PM Lethal diquat poisoning manifesting as central pontine myelinolysis and acute kidney injury: A case report and literature review - PubMed

performed. Continuous renal replacement therapy and continuous venovenous hemodiafiltration with
hemoperfusion were performed, and methylprednisolone was administered. Five days after admission,
the patient developed disturbance of consciousness and positive bilateral Babinski signs. Head
computed tomography demonstrated hypodensity in the pons. At 11 days after admission, brain
magnetic resonance imaging showed acute pontine demyelination. At 15 days after admission, the
patient died of multiple organ dysfunction syndrome. We encountered a case of diquat poisoning
with central pontine myelinolysis and acute kidney injury. This case highlights the clinical value of
neuroimaging examination for early diagnosis of central pontine myelinolysis.

Keywords: Diquat poisoning; acute kidney injury; central pontine myelinolysis; consciousness
disorder; multiple organ dysfunction; neuroimaging.

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Figure 1. Brain magnetic

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2/11/23, 2:12 PM Lethal diquat poisoning manifesting as central pontine myelinolysis and acute kidney injury: A case report and literature review - PubMed

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