HPLC DETECTION OF SERUM AND URINARY PARAPHENYLENE DIAMINE (PPD) LEVEL AND ITS METABOLITES IN RELATION TO CARDIAC TOXICITY

Document Type : Original Article

Authors

1 department of forensic and clinical toxicology cairo university

2 department of forensic medicine and clinical toxicology cairo university

3 Forensic & Clinical Toxicology Department, Faculty of medicine, Cairo University

4 Luxor international hospital

5 department of critical medicine cairo university

6 department of critical care cairo university

7 department of forensic medicine and toxicology princess Noura University Saudi Arabia

Abstract

Hair dye poisoning is an emerging big problem in Upper Egypt. The main component of hair dye causing toxicity is para-phenylenediamine (PPD). Ingestion of PPD could be accidental or suicidal. After oral intake it is metabolized in the liver into N-mono- (MAPPD) and N,N′- diacetylated (DAPPD) metabolites. Tissue damage after PPD ingestions occurs due to increased levels of free radical and oxidative stress that deplete tissue glutathione. Cardiac toxicity is a complication of PPD poisoning. It could be manifested by hypotension, different patterns of arrhythmia; in addition, myocarditis and elevated cardiac biomarkers were also found. Serum and urinary levels of PPD, N-acetyl-p-phenylenediamine (MAPPD) and N--diacetyl-p-phenylenediamine (DAPPD) were measured by HPLC. A prospective cohort study was planned to determine relation between the serum and urinary PPD, N-acetyl-p-phenylenediamine (MAPPD) and N,on -diacetyl-p-phenylenediamine (DAPPD) levels with cardiac manifestations of poisoned patient. Forty patients completed the diagnosis to have acute poisoning following hair dye ingestion. PPD and its metabolite concentrations did not show any significant correlation with the prevalence of cardiac toxicity and could not predict its occurrence among studied patient (p-value< .05)

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