{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T10:34:56Z","timestamp":1766399696267,"version":"3.48.0"},"reference-count":18,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:00:00Z","timestamp":1764806400000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Paraquat (PQ) is a highly toxic herbicide that causes severe poisoning. It mainly affects the lungs, liver, and kidneys. When ingested intentionally, it has a high mortality rate due to the absence of an effective antidote. We present a rare case of a 35\u2010year\u2010old female with deliberate ingestion of paraquat for a suicide attempt. Initially, she was treated conservatively at a local clinic; however, 2\u2009days post\u2010ingestion, she presented to the emergency department of a tertiary care hospital with complaints of respiratory distress, dysphagia, and mucocutaneous ulcerations. On laboratory examination, liver and renal function tests were deranged (AST 150\u2009U\/L, ALT 250\u2009U\/L, creatinine 18\u2009mg\/dL), and imaging revealed right\u2010sided pneumothorax. Intensive supportive management (corticosteroids, antibiotics, N\u2010acetylcysteine, and hemodialysis) was initiated, but the patient rapidly deteriorated, ultimately requiring mechanical ventilation; unfortunately, she succumbed to multi\u2010organ failure in the Intensive Care Unit (ICU) within an hour of admission. This case report illustrates the novelty of paraquat poisoning and its characteristic clinical presentation (hepatorenal involvement), with atypical Daisley\u2013Barton syndrome in Pakistan. Increased awareness and timely, precise management are crucial for preventing fatal complications, especially in resource\u2010limited regions, and for mitigating serious case consequences.<\/jats:p>","DOI":"10.1002\/ccr3.71588","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T05:29:31Z","timestamp":1764912571000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Paraquat Poisoning: A Case of Daisley\u2013Barton Syndrome and Hepatorenal Failure"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7357-1977","authenticated-orcid":false,"given":"Ali","family":"Gohar","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Lahore General Hospital  Lahore Punjab Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5248-0749","authenticated-orcid":false,"given":"Muhammad Husnain","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Medicine S. Tentishev Asian Medical Institute  Kant Kyrgyzstan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asad Ullah","family":"Mahmood","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Lahore General Hospital  Lahore Punjab Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Usama","family":"Naghman","sequence":"additional","affiliation":[{"name":"Punjab Medical College  Faisalabad Punjab Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4885-0410","authenticated-orcid":false,"given":"Abdul Rehman Shahid","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Lahore General Hospital  Lahore Punjab Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0904-7162","authenticated-orcid":false,"given":"Hamza","family":"Zaheer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Ameer\u2010ud\u2010Din Medical College, PGMI\/LGH  Lahore Punjab Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2398-178X","authenticated-orcid":false,"given":"Hamza Hafeez","family":"Farooqi","sequence":"additional","affiliation":[{"name":"Lahore General Hospital  Lahore Punjab Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marium Nadeem","family":"Khan","sequence":"additional","affiliation":[{"name":"Shifa College of Medicine  Islamabad Islamabad Capital Territory Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8599-6861","authenticated-orcid":false,"given":"Masab","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Punjab Medical College, Faisalabad Medical University  Faisalabad Punjab Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.5020"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2017.05.002"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MS9.0000000000001166"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010023\u201015505\u20101"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.4103\/0972\u20105229.117074"},{"key":"e_1_2_14_7_1","first-page":"210","article-title":"A Case Report of Paraquat Poisoning","volume":"19","author":"Gupta N.","year":"2018","journal-title":"Journal of the Indian Academy of Clinical Medicine"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102125.2011.04026.x"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000013745"},{"issue":"3","key":"e_1_2_14_10_1","first-page":"180","article-title":"Spontaneous Pneumothorax in Acute Paraquat Toxicity","volume":"39","author":"Daisley H.","year":"1990","journal-title":"West Indian Medical Journal"},{"issue":"11","key":"e_1_2_14_11_1","first-page":"1000","article-title":"Immunosuppressive Therapy in Lung Injury due to Paraquat Poisoning: A Meta\u2010Analysis","volume":"48","author":"Agarwal R.","year":"2007","journal-title":"Singapore Medical Journal"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/096032718700600107"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-199005040-00002"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fct.2014.04.038"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.etap.2013.07.009"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.2017.v107i5.12306"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010017\u201002527\u20100"},{"issue":"8","key":"e_1_2_14_18_1","article-title":"Glucocorticoid With Cyclophosphamide for Paraquat\u2010Induced Lung Fibrosis","author":"Li L. R.","year":"2014","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.19287"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.71588","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T10:31:50Z","timestamp":1766399510000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.71588"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":18,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/ccr3.71588"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.71588","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"type":"print","value":"2050-0904"},{"type":"electronic","value":"2050-0904"}],"subject":[],"published":{"date-parts":[[2025,12]]},"assertion":[{"value":"2025-05-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71588"}}