Adrenal abnormaliities in paraquat poisoning

Summary  TWELVE of 23 fatal cases of paraquat poisoning had abnormal adrenal histology at autopsy. Complete necrosis of both cortices were seen in seven, and focal cortical necrosis in five. The degree of necrosis reflected, in general, the severity of poisoning but focal necrosis was seen in three patients who had less fulminant, but fatal clinical course. All patients had been treated with corticosteroids from the time of diagnosis of poisoning. It is concluded that corticosteroids, as adrenal replacement therapy, may have a role in the management of paraquat poisoning.