Acute renal failure due to paraphenylenediamine intoxication (Hair Colouring Dye): Report of a case and discussion of management guidelines based on a review of the literature

Paraphenylenediamine (PPD) poisoning has been known for many years. Accidental or deliberate ingestion of Paraphenylenediamine has rarely been reported, but is potentially severe. We report a case of systemic poisoning with paraphenylenediamine (PPD) presenting with characteristic features of severe angioneurotic edema, rhabdomyolysis and intravascular hemolysis with hemoglobinuria culminating in acute renal failure. There is no specific antidote available but some guidelines for management of such a case are reviewed which includes therapy with gastric lavage, IV fluid infusion, mechanical ventilation, alkalinization of urine, corticosteroids, vasopressors and renal replacement therapy.