Acute pancreatitis due to zinc phosphide ingestion

Sarma, P. S. A.; Narula, Jagat

doi:10.1136/pgmj.72.846.237

Cited by 23 publications

(18 citation statements)

References 3 publications

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“…Also, some rare complications have been reported such as pulmonary edema 2, acute pancreatitis, transient leukopenia, and transient hyperglycemia 4, 5, 6.…”

Section: Introductionmentioning

confidence: 99%

Hepatotoxicity due to zinc phosphide poisoning in two patients: role of N‐acetylcysteine

Oghabian

Afshar

Rahimi

2016

Clinical Case Reports

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Key Clinical MessageZinc phosphide (Zn3P2/ZnP) is used as a rodenticide. The most common signs of toxicity are nausea, vomiting, hypotension, and metabolic acidosis; patients presenting such signs are referred to the emergency department (ED) of the hospitals. Therefore, this study aimed to report two cases of hepatotoxicity following accidental and intentional ZnP poisoning and successful management with N‐acetylcysteine (NAC).

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“…Also, some rare complications have been reported such as pulmonary edema 2, acute pancreatitis, transient leukopenia, and transient hyperglycemia 4, 5, 6.…”

Section: Introductionmentioning

confidence: 99%

Hepatotoxicity due to zinc phosphide poisoning in two patients: role of N‐acetylcysteine

Oghabian

Afshar

Rahimi

2016

Clinical Case Reports

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“…1, 2, 3 and 4). Previous studies also revealed AP induction by excessive Zn intake in different animal models such as in mice, ducklings, dogs, and humans [11][12][13][14][15][16].…”

Section: Discussionmentioning

confidence: 97%

“…The pancreas is very sensitive to Zn levels, as it is one of the most important organs in which the most rapid accumulation and turnover of retained Zn occurs [10]. Excess intake of Zn has been reported to induce acute pancreatitis (AP) in many animal models including mice, ducklings, and dogs, and in humans, due to oxidative stress [11][12][13][14][15][16][17]. Cu deficiency is another factor that has been observed to induce AP in rat model, again reported to result from oxidative stress [18].…”

Section: Introductionmentioning

confidence: 99%

Attenuation of Zn-Induced Acute Pancreatitis in Wistar Rat Fed on Cu- and Mg- Enriched Modified Poultry % MathType!Translator!2!1!AMS LaTeX.tdl!TeX -- AMS-LaTeX!% MathType!MTEF!2!1!+-% feaaeaart1ev0aaatCvAUfeBSjuyZL2yd9gzLbvyNv2CaerbuLwBLn% hiov2DGi1BTfMBaeXatLxBI9gBaerbd9wDYLwzYbItLDharqqtubsr% 4rNCHbGeaGqiVu0Je9sqqrpepC0xbbL8F4rqqrFfpeea0xe9Lq-Jc9% vqaqpepm0xbba9pwe9Q8fs0-yqaqpepae9pg0FirpepeKkFr0xfr-x% fr-xb9adbaqaaeGaciGaaiaabeqaamaabaabaaGcbaacbeGaa8xrai% aa-DgacaWFNbWaaWbaaSqabeaaiiqacqGFOoqwaaaaaa!3

Taneja

Mandal

2008

Biol Trace Elem Res

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Zinc (Zn) consumption has increased in many populations either due to the increased intake of Zn-fortified foods as in the USA or in agricultural food stuffs as in some Indian states during the last decade. Its excessive intake has been reported to induce acute pancreatitis (AP) in many studies due to increase in oxidative stress that was further reported to cause Cu and Mg deficiencies. This led us to design a modified poultry egg (ME(Psi)) enriched with Cu and Mg along with other antioxidants, and its efficacy on Zn-induced AP was studied in male Wistar rats. In one set, the rats were fed on equacaloric semi-synthetic basal diet containing 20 mg Zn/kg diet (control, group I), and Zn-induced AP-I diet and AP-II diet containing 40 and 80 mg Zn/kg diet (groups II and III) for 180 days, respectively. In another set, the rats were initially fed on Zn-induced AP-I and AP-II diets for 90 days and then shifted to ME(Psi)-mixed Zn-induced AP-I and AP-II diets in groups IIME and IIIME for another 90 days. At the end of the experiment, data displayed increased serum and urinary Zn, Cu, and Mg levels in groups II and III rats, which were reduced and approached closer to control group I after ME(Psi) feeding in groups IIME and IIIME rats. Transmission electron microscopic studies of acinar cells revealed progressive dilation, vesicularization, and degeneration of endoplasmic reticulum (ER), and decrease in zymogen granules (ZG) in groups II and III rats in contrast to their curvilinear or concentric long parallel running cisternal profile of ER in control group I. The treatment of ME(Psi) helped in the restoration of the ER profile and ZG number, approaching closer to the control group I. The degree of recovery was dependent upon the degree of toxicity caused by the amount of Zn given in the diet. The results of this study suggest that ME(Psi)-mixed diet can protect the acinar cells from the deleterious effects of Zn by decreasing the oxidative stress.

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“…According to the autopsy reports, congestion in the liver was identified in 3/5 of the dead patients and 2/5 of these patients had both congestion and necrotic spots in the liver. Sarma et al (27) have reported that zinc phosphide ingestion leads to acute pancreatitis. In our study, four of our patients had higher than average amylase values.…”

Section: Discussionmentioning

confidence: 99%

A Rare Type of Suicide Attempt in East Turkey: Acute Zinc Phosphide Poisoning

Gökdemir¹,

Kaya²,

Söğüt³

et al. 2013

JAEM

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Objective: The purpose of this study was to predict the clinic and demographic profile of patients who attempt suicide by poisoning with zinc phosphide. Material and Methods: All cases presenting to the ED from January 1 st 2009 to April 30 th 2011 due to Acute Zinc Phosphide Poisoning were retrospectively reviewed. Results: All cases had taken the pharmaceutical product in an attempt to commit suicide. The average age of the cases was 25.4 years. Sixteen of the cases were female (76%), and five (24%) were male; all of the cases who died were female. In terms of marital status, 4 (19%) of the cases were single or unmarried. A total of 8 (38%) cases were unconscious and had low pH levels (<7.35), and 9 (43%) cases had signs of shock, such as hypotension and tachycardia. The average level of bicarbonate in the arterial blood gas of the cases was 23.20 mmol/L and the average amount of time (admission time) taken to bring the patients from the place where they were poisoned to the ED was 2.40 hours. According to the autopsy results of the dead patients, there were findings of liver congestion, liver necrosis, pancreatic edema and hemorrhagic points together with inflammation in the kidneys. Conclusion: Although it is a rare form of suicide attempt, the mortality rate for patients with zinc phosphide poisoning is high. Early resuscitation can have positive effects on morbidity and mortality. Patients who suffer from zinc phosphide poisoning must be monitored under intensive care conditions. (JAEM 2013; 12: 76-9 Olguların yaş ortalaması 25,4 yıl idi. Olguların 16'sı (%76) bayan ve 5'i (%24) erkek idi; ölen olguların hepsi bayan idi. Dört (%19) olgu bekar veya yanlızdı. Sekiz (%38) olguda şuur kaybı ve düşük pH (<7,35) düzeyi ve 9 (%43) olguda hipotansiyon ve taşikardi gibi şok bulguları vardı. Ortalama bikarbonat düzeyi 23,20 mmol/L ve zehirlenmenin olduğu yer ile acil servise kabul edilinceye kadar geçen zaman ortalaması 2,40 saat idi. Otopsi sonuçlarına göre ölen olgularda,karaciğer konjesyonu,karaciğer nekrozu,pancreas ödemi ve böb-reklerde kanama odakları ile beraber enflamasyon vardı. Sonuç: Nadir bir özkıyım şekli olmasına rağmen, çinko fosfid zehirlenmesi olan hastalar için mortalite oranı yüksektir. Erken müdahale mortalite ve morbiditeye olumlu etki yapabilir. Çinko fosfid zehirlenmesine maruz kalan hastaların yoğun bakım şartlarında takibi yapılmalıdır. (JAEM 2013; 12: 76-9) Anahtar kelimeler: Özkıyım girişimi, çinko fosfid, zehirlenme, acil servis

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Acute pancreatitis due to zinc phosphide ingestion

Abstract: The case of a young woman is described who suffered from acute pancreatitis related to the ingestion of zinc phosphide. This unusual complication was successfully managed with conservative treatment.

Cited by 23 publications

References 3 publications

Hepatotoxicity due to zinc phosphide poisoning in two patients: role of N‐acetylcysteine

Hepatotoxicity due to zinc phosphide poisoning in two patients: role of N‐acetylcysteine

A Rare Type of Suicide Attempt in East Turkey: Acute Zinc Phosphide Poisoning

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