Para Phenylene Diamine Poisoning: Hepatic and Renal Damage

Suicide is the second leading cause of death and it kills one person in every 40 seconds mostly between age limits 15-29 years. The global official surveys conducted reported higher death rates in low and middle income countries; however, women were affected more than men. Poisoning with chemicals is known to be a preferred method of suicide. The morbidity and mortality data following hair dye poisoning peaked in last few years. Interestingly, poisoning with Para Phenylene Diamine (PPD) is an emerging way of intentional self-harm in developing countries of Asia and Africa. We report here a case of 15 years old patient brought to our hospital emergency unit. The patient developed sudden onset of acute cervico-facial edema, lacrimation and abdominal pain, later followed by deranged liver and renal functions progressing towards liver and renal failure. The history selectively indicated the ingestion of a hair dye locally called “Kala Pathar” which predominantly contains PPD. The lack of specific diagnostic tests, a specific antidote for PPD poison and the importance of early supportive treatment are discussed.