Methemoglobinemia in aluminum phosphide poisoning

Shadnia, S. and Soltaninejad, K. and Hassan Ian-Moghadam, H. and Sadeghi, A. and Rahimzadeh, H. and Zamani, N. and Ghasemi-Toussi, A. and Abdollahi, M. (2011) Methemoglobinemia in aluminum phosphide poisoning. Human and Experimental Toxicology, 30 (3). pp. 250-253.

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Abstract

Introduction. Acute aluminum phosphide (AlP) poisoning is one of the most common causes of acute pesticide poisoning in Iran. Hydrogen phosphide or phosphine gas is produced following reaction of AlP with water even at ambient humidity. Methemoglobinemia is a rare finding following phosphine poisoning. In this paper, two cases of fatal AlP poisoning complicated by methemoglobinemia are reported. Case Report. Two patients presented following suicidal ingestion of AlP tablets. In the Emergency Department (ED), they received gastric lavage with sodium bicarbonate and potassium permanganate. Both of them received supportive care. In each case, hematuria and hemolysis were significant events. The patients also showed a decrease in O2 saturation in spite of high FIO2. Methemoglobin levels of 40 and 30 were detected by co-oximetry. Neither patient responded to treatment (ascorbic acid in one case, methylene blue in the other). Both patients died due to systemic effects of phosphine poisoning. Discussion and conclusion. Hemolysis and methemoglobinemia may complicate the course of phosphine poisoning that seems resistant to methylene blue and ascorbic acid. Therefore, other treatments including hyperbaric oxygen therapy and exchange blood transfusion should be considered. © The Author(s) 2010.

Item Type: Article
Additional Information: cited By 30
Uncontrolled Keywords: activated carbon; aluminum phosphide; ascorbic acid; bicarbonate; gluconate calcium; magnesium sulfate; methemoglobin; methylene blue; permanganate potassium; sorbitol, adult; aluminum phosphide poisoning; article; case report; food poisoning; hematuria; hemolysis; human; intensive care unit; intoxication; male; methemoglobinemia; oximetry; oxygen saturation; priority journal; repeated drug dose; stomach lavage; suicide attempt; treatment response, Adult; Aluminum Compounds; Antidotes; Ascorbic Acid; Calcium Gluconate; Fatal Outcome; Fluid Therapy; Humans; Magnesium Sulfate; Male; Methemoglobinemia; Methylene Blue; Middle Aged; Pesticides; Phosphines; Sodium Bicarbonate; Suicide, Attempted
Subjects: QV Pharmacology
Depositing User: somayeh pourmorteza
Date Deposited: 05 Jan 2019 11:34
Last Modified: 05 Jan 2019 11:34
URI: http://eprints.iums.ac.ir/id/eprint/7425

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