Paraquat poisoning and the lung pathology; vascular injury leading to thrombotic microangiopathy is the primary pathological event

Paraquat is an agent that is used in suicide in many agricultural societies.1‒3 Its ingestion is almost always fatal. Respiratory failure plays a significant role in the demise of these victims as pulmonary fibrosis ultimately occurs. The literature abounds with theories as to the pathogenesis of paraquat toxicity, most of which focuses on the inflammatory infiltrates and the pneumocytes’ response in the lung in paraquat poisoning. As a result immunosuppressive and anti-fibrosis therapies have been tailored against these latter pathophysiological mechanisms,4,5 needless to say these therapies have been met with little success.