Hair dye poisoning and rhabdomyolysis: a case report
Abstract
Intoduction: Hair dye ingestion is a rare cause of toxicity in Pakistan. There are several case reports from India with variable presentations of hair dye toxicity. We are presenting case report of a patient with accidental hair dye ingestion.
Case Presentation: A 55 years male who accidentally ingested hair dye. Within 2 hours, he developed acute respiratory distress, facial edema, plethora and stridor. He underwent emergent tracheostomy in a nearby hospital and was transferred to AKUH ER. In the ER, he was managed for trachietis along with aspiration pneumonitis and chemical esophagitis. He was transferred to the special care unit where he was found to have decreased urine output. On catheterized there he was noticed to have red colored urine. Lab work up revealed acute kidney injury. BUN 17 mg/dl/Cr 1.5 mg/dl increased to BUN 67 mg/dl /Cr 4.4 mg/dl. Electrolytes revealed hyperkalemia and acidosis K 5.3 mmol/L BIC 18.5mmol/L. CPK was sent which was 39863 IU/L and Phosphate 7.8 mg/dl. Diagnosis of rhabdomyolysis was made. Patient was aggressively hydrated, and urine was alkalinized with IV bicarbonate. Despite this, he developed oliguria and worsening azotemia, and had to be placed on hemodialysis.
Result: After few sessions of hemodialysis his urine output improved and renal functions stabilized without any requirement for long term hemodialysis.
Conclusion: Hair dye toxicity can be fatal if not recognized early. There is no antidote available. Rhabdomyolysis is a complication and needs to be managed aggressively in order to prevent long term morbidity.
Hair dye poisoning and rhabdomyolysis: a case report
Auditorium Pond Side
Intoduction: Hair dye ingestion is a rare cause of toxicity in Pakistan. There are several case reports from India with variable presentations of hair dye toxicity. We are presenting case report of a patient with accidental hair dye ingestion.
Case Presentation: A 55 years male who accidentally ingested hair dye. Within 2 hours, he developed acute respiratory distress, facial edema, plethora and stridor. He underwent emergent tracheostomy in a nearby hospital and was transferred to AKUH ER. In the ER, he was managed for trachietis along with aspiration pneumonitis and chemical esophagitis. He was transferred to the special care unit where he was found to have decreased urine output. On catheterized there he was noticed to have red colored urine. Lab work up revealed acute kidney injury. BUN 17 mg/dl/Cr 1.5 mg/dl increased to BUN 67 mg/dl /Cr 4.4 mg/dl. Electrolytes revealed hyperkalemia and acidosis K 5.3 mmol/L BIC 18.5mmol/L. CPK was sent which was 39863 IU/L and Phosphate 7.8 mg/dl. Diagnosis of rhabdomyolysis was made. Patient was aggressively hydrated, and urine was alkalinized with IV bicarbonate. Despite this, he developed oliguria and worsening azotemia, and had to be placed on hemodialysis.
Result: After few sessions of hemodialysis his urine output improved and renal functions stabilized without any requirement for long term hemodialysis.
Conclusion: Hair dye toxicity can be fatal if not recognized early. There is no antidote available. Rhabdomyolysis is a complication and needs to be managed aggressively in order to prevent long term morbidity.