Indian Journal of Forensic Medicine & Toxicology

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Intravascular Hemolysis after Aluminum Phosphide Poisoning


Affiliations
1 Forensic Medicine Dept., Tehran University of Medical Sciences, Baharloo Hospital, Tehran, Iran, Islamic Republic of
2 Kurdistan Digestive and Hepatic Diseases Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran, Islamic Republic of
     

   Subscribe/Renew Journal


Background: hemolysis is a rare finding in patients with Aluminum phosphide (AlP) poisoning. In this report a patient with the AlP poisoning and intravascular hemolysis will be presented.

Case Report: The patient was a 25 years old man who ingested three tablets (9gr) of AlP for suicide attempt one hour before admission to poisoning emergency ward of Baharloo hospital in Tehran. He had nausea, vomiting, heartburn, and mild metabolic acidosis on the arrival to the hospital. The patient had no fever, loss of consciousness and respiratory distress. History of specific disease and concomitant use of other drugs was not mentioned. Supportive care was done for the patient. He was icteric and his serum bilirubin was increased and hemoglobin was decreased 24 hour after admission during hospitalization. Laboratory tests were negative for hepatitis and liver, gall bladder and bile duct ultrasound was normal. G6PD (glucose 6 phosphate dehydrogenase) deficiency was confirmed. The patient was discharged with the good condition after a week.

Conclusion: Due to lack of other drug use and the underlying causes for hemolysis in this case, it seems ALP should be added to the etiologies of hemolysis in patients with glucose 6-phosphate dehydrogenase deficiency.


Keywords

Aluminum phosphide, Poisoning, Hemolysis, G6PD deficiency
Subscription Login to verify subscription
User
Notifications
Font Size


  • Siwach SB, Yadav DR, Arora B, Dalal S, Jagdish., 1988. Acute aluminium phosphide poisoning: an epidemiological, clinical and histopathological atudy. J Assoc Phys India. 36, 594-8.

  • Shadnia S, Sasanian G, Allami P, Hosseini A, Ranjbar A, Amini-shirazi N, et al., 2009. A retrospective 7-years study of aluminium phosphide poisoning in Tehran: Opportunities for prevention. Hum Exp Toxicol. 28, 209-13.

  • Perry HE. Rodenticides. In: Shannon MW, Borron SW, Burns MJ, editors., 2007. Haddad and Winchester’s clinical management of poisoning and drug overdose. 4th ed. Philadelphia: W.B. Saunders Co. pp.1218-1225.

  • Okolie NP, Aligbe JU, Osakue EE., 2004. Phostoxininduced biochemical and pathomorphological changes in rabbits. Indian J Exp Biol. 42, 1096-9.

  • Chugh SN., 1992. Aluminium phosphide poisoning, present status and management. J Assoc Phys India. 40, 401-5.

  • Sood AK, Mahajan A, Dua A., 1997. Intravascular haemolysis after aluminium phosphide ingestion. J R Soc Res. 90, 47-48.

  • Madan K, Chalmalasetty SB, Sharma M, Makharia G., 2006. Corrosive like stricture cause by ingestion of aluminium phosphide. Natl Med J India. 19, 313-4.

  • Shadnia S, Soltaninejad K, Hassanian-Moghadam H, Sadeghi A, Rahimzadeh H, Zamani N, et al., 2011. Methemoglobinemia in aluminium phosphide poisoning. Hum Exp Toxicol 30, 250-3.

  • Soltaninejad K, Nelson LS, Khodakarim N, Dadvar Z, Shadnia Sh., 2011. Unusual complication of aluminum phosphide poisoning: Development of hemolysis and methemoglobinemia and its successful treatment. Indian J Crit Care Med. 15, 117-19.

  • Srinivas R, Agarwal R, Jairam A, Sakhuja V., 2007 Intravascular haemolysis due to glucose 6 phosphate dehydrogenase deficiency in a patient with aluminium phosphide poisoning. Emerg Med J. 24, 67–68.

  • Aggarwal P, Handa R, Wig N, Biswas A, Saxena R, Wali JP., 1999. Intravascular hemolysis in aluminium phosphide poisoning. Am J Emerg Med. 17, 488-9.

  • Chin KL, Mai X, Meaklim J, Scollary GR, Leaver DD., 1992. The interaction of phosphine with hemoglobin and erythrocytes. Xenobiotica. 22, 599-607.

  • Chugh SN, Mittal A, Seth S, Chugh K., 1995. Lipid peroxidation in acute aluminium phosphide poisoning. J Assoc Physicians India. 43, 265-6.

  • Chittora MD, Meena SR, Gupta DK, Bhargava S., 1994. Acute hepatic failure in aluminum phosphide poisoning. J Assoc Physicians India. 42, 924.

  • Gellady AM, Greenwood RD., 1972. G-6-PD hemolytic anemia complicating diabetic ketoacidosis. J Pediatr 80, 1037-1038.


Abstract Views: 624

PDF Views: 0




  • Intravascular Hemolysis after Aluminum Phosphide Poisoning

Abstract Views: 624  |  PDF Views: 0

Authors

M. Arefi
Forensic Medicine Dept., Tehran University of Medical Sciences, Baharloo Hospital, Tehran, Iran, Islamic Republic of
V. Allahyar Parsa
Forensic Medicine Dept., Tehran University of Medical Sciences, Baharloo Hospital, Tehran, Iran, Islamic Republic of
V. Yousefinejad
Kurdistan Digestive and Hepatic Diseases Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran, Islamic Republic of
N. Darvishi
Kurdistan Digestive and Hepatic Diseases Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran, Islamic Republic of

Abstract


Background: hemolysis is a rare finding in patients with Aluminum phosphide (AlP) poisoning. In this report a patient with the AlP poisoning and intravascular hemolysis will be presented.

Case Report: The patient was a 25 years old man who ingested three tablets (9gr) of AlP for suicide attempt one hour before admission to poisoning emergency ward of Baharloo hospital in Tehran. He had nausea, vomiting, heartburn, and mild metabolic acidosis on the arrival to the hospital. The patient had no fever, loss of consciousness and respiratory distress. History of specific disease and concomitant use of other drugs was not mentioned. Supportive care was done for the patient. He was icteric and his serum bilirubin was increased and hemoglobin was decreased 24 hour after admission during hospitalization. Laboratory tests were negative for hepatitis and liver, gall bladder and bile duct ultrasound was normal. G6PD (glucose 6 phosphate dehydrogenase) deficiency was confirmed. The patient was discharged with the good condition after a week.

Conclusion: Due to lack of other drug use and the underlying causes for hemolysis in this case, it seems ALP should be added to the etiologies of hemolysis in patients with glucose 6-phosphate dehydrogenase deficiency.


Keywords


Aluminum phosphide, Poisoning, Hemolysis, G6PD deficiency

References