Management of 2, 4- Dichlorophenoxyacetic Acid Intoxication by Hemodialysis: A Case Report

Background: the herbicide 2, 4-dichlorophenoxyacetic acid (2, 4-d) can cause moderate to lethal poisoning. although urine alkalization has been recommended as the main treatment, hemodialysis (hd) may be more effective in severe cases. case: on 24th june 2014, a 53- year-old man ingested a high amount of 40% 2, 4-d. he suffered from mouth and epigastric burning sensation, vomiting and nausea. he was treated, in emam reza’s hospital of mashhad university of medical sciences, mashhad , iran, with maintenance daily fluid infusion plus 10 meq/l nahco3. up to 9 hours after exposure, he became progressively stuporous. he developed diarrhea and hypotension, bp=100/60, unresponsive to volume replacement therapy. he received regular hemodialysis (hd) with bicarbonate for three hours. at the end of hd, his blood pressure rose to 110/70 and the level of consciousness began to improve. four hours later, he was fully conscious with stable blood pressure (130/80 mmhg).conclusion: hd may be an effective, safe and fast method for 2, 4-d high dose intoxication induced coma.