A Rare but Potentially Fatal Poisoning; Aluminum Phosphide Poisoning

Tolunay, Orkun; Çelik, Tamer; Yücel, Gülperi; Özdemir, Ulaş; Atmiş, Anıl; Sucu, Asena; Çelik, Ümit

doi:10.4274/cayd.29484

Cited by 4 publications

(2 citation statements)

References 13 publications

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“…Tolunay ve ark. yapmış oldukları çalış-mada 14 yaşında kız olgunun özkıyım amaçlı alüminyum fosfit içeren Celphos tablet alımı sonrasında hastaneye kaldırıldığı uygulana tedavi sonrasında hastanın taburcu edildiği bildirilmektedir (22). Hakimoğlu ve ark.…”

Section: Tartışma Ve Sonuçunclassified

Sıra Dışı Bir Kaza ile Meydana Gelen ve Ölümle Sonuçlanan Alüminyum Fosfit Zehirlenmesi: Olgu Sunumu

2018

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GirişDepolanmış tahılları ve ürünleri haşere ve böcek-lerden korumak için alüminyum fosfit kullanılmakta-dır. Alüminyum fosfit; celphos, quickphos, synfume ve phosfume gibi farklı ticari preparatlar halinde İran ve Hindistan gibi ülkelerde oldukça sık kullanılmaktadır (1). Kuzey Hindistan'da genç ergenlerde özkıyım amaçlı alüminyum fosfit kullanımı sonrası ölüm olgularına sık-lıkla rastlanmaktadır (2). İran'da da son yıllarda özkıyım amaçlı alüminyum fosfit en sık kullanılan ajanlardan biri olarak saptanmıştır (3). ÖzetAlüminyum fosfit nemle teması halinde fosfin gazı oluşturan yüksek toksisiteye sahip bir insektisittir. Tarım ürünlerinde kalıntı bırakmaması ve difüzyon kapasitesinin çok yüksek olması nedeniyle uygulandığı ortamdaki tüm canlıları farklı gelişim evrelerinde öldürebilmesi nedeniyle sıkça kullanılmaktadır. Halen özgün bir antidotu bulunmayan alüminyum fosfit zehirlenmelerinde ölüm oranları alınan doza bağlı olarak %30 ile %100 arasında değişmek-tedir. Bu çalışmada; bir binanın zemin katında bulunan gıda deposunun fumigasyonu sonrasında, birinci kattaki evinde sıra dışı bir şekilde alüminyum fosfit zehirlenmesi sonucu ölen 13 yaşındaki kız olgu ele alınmıştır. Olgunun otopsi raporu, toksikoloji ve patoloji bulguları birlikte değerlendirilerek konunun literatür eşliğinde tartışılması, oral kullanımı ve inhalasyonu halinde yüksek ölüm riski taşıyan alüminyum fosfitin ülkemizde kontrolsüz satışının ve kullanımının sebep olabileceği bazı olumsuzluklarla birlikte bazı çözüm önerilerinin vurgulanması amaçlanmıştır.Anahtar Kelimeler: Alüminyum Fosfit; Zehirlenme; Otopsi; Toksikoloji. AbstractAluminium phosphide is an insecticide that shows highly toxic activity when it reacts with water or moister and becomes phosphine. Because it has high diffusion capacity, it can kill all the organisms in different growth phases in the area that it is used. However, it is used frequently due to not to find rests on plants. There is not a specific antidote for aluminium phosphide and mortality from 30% to 100% in poisoning and it is related with exposure. In this study, we present 13 years girl case who was poisoned by aluminium phosphide. He was found in his apartment which is at first floor, after fumigation of food store at the basement. We aim to evaluate by autopsy findings, chemical and histopathological findings together and to discuss with literature results. In addition, we want to discuss about solution of uncontrolled dealing and using of aluminium phosphide in our country.

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Section: Tartışma Ve Sonuçunclassified

Sıra Dışı Bir Kaza ile Meydana Gelen ve Ölümle Sonuçlanan Alüminyum Fosfit Zehirlenmesi: Olgu Sunumu

2018

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“…Phosphine gas is an extremely poisonous gas. It is mostly used to improve the storage conditions of agricultural products such as animal feed, leaf tobacco, and grain, and to repel or kill pests such as rodents and insects 1 . Aluminum phosphite is a chemical used as an insecticide and pesticide, and after being taken orally as a tablet, it reacts with the acidic environment of the stomach and turns into phosphine gas.…”

Section: Introductionmentioning

confidence: 99%

Rapid Death from Aluminum Phosphide Poisoning

ALPASLAN¹

2023

Eurasian Journal of Toxicology

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Abstract Aluminum phosphite is a chemical used as an insecticide and pesticide to improve the storage conditions of agricultural products. Combined with the humidity in the air or after being taken orally as a tablet, it reacts with the acidic environment of the stomach and turns into phosphine gas and can cause poisoning. Suicidal use is also common. When poisoning develops, deep metabolic acidosis, hypotensive shock, acute respiratory failure, multi-organ failure, cardiac arrest and death may occur. Resistant hypotension and deep metabolic acidosis are the most important indicators of poor prognosis. In this case, an 18 year old male patient was brought to the emergency room after taking 3 tablets of aluminum phosphide. The patient was unconscious and had hypotensive shock. Despite gastric lavage, massive fluid replacement, positive inotropes, sodium bicarbonate, intravenous N acetyl cysteine loading, and hemodialysis, the patient died 6 hours after admission to the emergency department.

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Aluminum Phosphide Toxicity

Ari,

Turhan,

Baspinar

et al. 2022

Indian Pediatrics Case Reports

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Background: Aluminum phosphides (ALPs) are still being used in developing countries as a pesticide despite the fact that ingestion and/or inhalation can cause significant morbidity and mortality. The generation of phosphine when ALP comes in contact with water leads to the blockade of electron transfer, which inhibits oxidative phosphorylation and in turn, cellular respiration in multiple organ systems. Clinical Description: A 3-year-old Turkish girl and her family were inadvertently exposed to overnight inhalation intoxication after a tablet of ALP was dissolved in water and used as a pesticide for Isot pepper, a local spice used in their household. The child presented with rapidly progressive respiratory distress and coma. The other members displayed mild respiratory symptoms. Management: At the time of admission, she was in altered sensorium, tachycardic, tachypneic, hypoxic, and in shock. She was immediately intubated and intermittent positive pressure ventilation started. Shock was managed as per the standard protocol. The child emanated garlic odor breath, had sluggishly reactive bilateral mitotic pupils. She had cardiorespiratory arrest within 30 min of intubation and could be revived. Despite supportive treatment, multiorgan dysfunction syndrome developed cardiac, pulmonary, renal, hepatic, coagulopathy, hyperglycemia, and metabolic acidosis. She succumbed to another cardiorespiratory arrest before plasmapheresis and continuous renal replacement therapy could be started in an attempt to eliminate the toxins. Consent for autopsy was not given. Conclusions: ALPs poisoning still occurs in developing countries and is a leading cause of mortality. The most common cause of death within the first 24 h is cardiovascular collapse.

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A Rare but Potentially Fatal Poisoning; Aluminum Phosphide Poisoning

Cited by 4 publications

References 13 publications

Sıra Dışı Bir Kaza ile Meydana Gelen ve Ölümle Sonuçlanan Alüminyum Fosfit Zehirlenmesi: Olgu Sunumu

Sıra Dışı Bir Kaza ile Meydana Gelen ve Ölümle Sonuçlanan Alüminyum Fosfit Zehirlenmesi: Olgu Sunumu

Rapid Death from Aluminum Phosphide Poisoning

Aluminum Phosphide Toxicity

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