{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T07:40:18Z","timestamp":1769845218490,"version":"3.49.0"},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To report on the management of a toddler who had accidental ingestion of an unknown amount of paraquat, with treatment including continuous renal replacement therapy (CRRT), steroids and antifibrinolytics at a tertiary\u2010level health system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A 16\u2010month\u2010old child weighing 10 kg accidentally ingested an unknown amount of Gramoxone containing paraquat. The child was transferred to a tertiary centre Paediatric Intensive Care Unit (PICU) where she was electively intubated and commenced on CRRT at 7 hours and 15 minutes post\u2010ingestion. She was also treated with activated charcoal, methylprednisolone, N\u2010acetylcysteine infusion and pirfenidone. Paraquat blood and urine samples were monitored throughout her PICU admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The child did not exhibit respiratory distress or significant hypoxia during the admission. She developed ulceration of the lips, mouth and tongue on day 2 which improved after 48 hours. Feed intolerance and pneumatosis intestinalis were managed conservatively. Interstitial changes were noted on chest x\u2010ray on day 3 and pirfenidone was initiated to minimise the risk of pulmonary fibrosis. The child was discharged from PICU to the general ward for further observation. At follow\u2010up, there has been no evidence of pulmonary fibrosis up to 6 months post\u2010discharge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This case highlights the toxicity of Paraquat and importance of early management and urgent transfer of paraquat poisoning cases to specialised medical centres. Prompt interventions including activated charcoal, N\u2010acetylcysteine, CRRT and pirfenidone can improve patient prognosis and reduce the risk of long\u2010term complications such as pulmonary fibrosis in paediatric paraquat toxicity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.16754","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T06:04:15Z","timestamp":1736402655000},"page":"509-513","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Management of Accidental Paraquat Ingestion in a Child"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8888-098X","authenticated-orcid":false,"given":"Emily","family":"Horsley","sequence":"first","affiliation":[{"name":"University of Queensland, Queensland Children's Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Chandler","sequence":"additional","affiliation":[{"name":"Queensland Children's Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Wainwright","sequence":"additional","affiliation":[{"name":"Queensland Children's Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Sashak Rishanghan","sequence":"additional","affiliation":[{"name":"Queensland Children's Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele Louise","family":"Cree","sequence":"additional","affiliation":[{"name":"Queensland Children's Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Humphreys","sequence":"additional","affiliation":[{"name":"Queensland Health  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neeta","family":"Rampersad","sequence":"additional","affiliation":[{"name":"Queensland Children's Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,1,8]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"Therapeutic Guidelines Toxicology and Toxinology 2020."},{"issue":"11","key":"e_1_2_12_3_1","first-page":"13192","article-title":"Inhibitory Effect of Pirfenidone on Pulmonary Fibrosis in Patients With Acute Paraquat Poisoning","volume":"13","author":"Ren W.","year":"2021","journal-title":"American Journal of Translational Research"},{"key":"e_1_2_12_4_1","unstructured":"UpToDate Pirfenidone Drug Information Paediatric Dose accessed 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