Reversible Myocardial Injury and Intraventricular Thrombus Associated with Aluminium Phosphide Poisoning

Hangouche, Abdelkader Jalil El; Fennich, Hala; Alaika, Oumaima; Dakka, Taoufiq; Raissouni, Zaineb; Oukerraj, Latifa; Doghmi, Nawal; Cherti, Mohamed

doi:10.1155/2017/6287015

Cited by 14 publications

(8 citation statements)

References 13 publications

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“…The present study revealed that troponin I showed a negative correlation with blood pressure. El Hangouche et al (2017) study is in accordance with our results that found a negative correlation between blood pressure and troponin I and stated that ALP toxicity induced myocardial injury and release of cardiac troponin. Akhtar et al (2015) also reported hypotension and increase in troponin I level after ALP exposure.…”

Section: Discussionsupporting

confidence: 93%

Assessment of the Role of Total Antioxidant Capacity and Troponin I as Possible Predictors for Phosphides -Induced Cardiotoxicity

Wahab

Shalaby

Awady

et al. 2020

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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Background: Metal phosphides are type of rodenticides that are extremely lethal with low safety and high mortality rates. They are commonly used as a powerful suicidal tool in Egypt and developing countries due to its low price and easy availability. Heart is a significant target organ of acute metal phosphides toxicity, causing myocardial damage and myocarditis. Aim: The study aimed to evaluate usefulness of total antioxidant capacity (TAC) and troponin I as predictive biomarkers for phosphides induced oxidative stress and cardiotoxicity among patients admitted to the Poison Control Center Ain Shams University Hospitals (PCC-ASUH). Methods and results: A prospective study included patients of both sexes presented to the PCC-ASUH with acute metal phosphides poisoning during six months period from July to December 2017. The demographic, intoxication and clinical data were collected for every patient. On admission investigations included electrocardiogram (ECG) in addition to TAC and troponin I levels. Outcome was also recorded. This study was conducted on 188 patients of both sexes with acute metal phosphides poisoning. The patients were classified according to the Poisoning Severity Score (PSS) into three groups; mild, moderate and severe. TAC value was significantly decreased in patients who developed cardiovascular manifestations and ECG abnormalities. Serum troponin I value was significantly higher in patients who developed cardiovascular manifestations and ECG abnormalities. Conclusion: The current study concluded that TAC and troponin I levels could be useful in predicting development of oxidative damage, cardiotoxicity and mortality after acute metal phosphides poisoning. Recommendations: The present study recommended the use of TAC and troponin I as useful markers for prediction of cardiotoxicity and mortality in patients with acute metal phosphides poisoning.

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Section: Discussionsupporting

confidence: 93%

Assessment of the Role of Total Antioxidant Capacity and Troponin I as Possible Predictors for Phosphides -Induced Cardiotoxicity

Wahab

Shalaby

Awady

et al. 2020

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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“…In other studies, mortality reported was 47% and 58.6%. 19 – 21 The higher mortality in children in our study may be because cases were due to accidental exposure when AlP was used for house fumigation. In other retrospective studies in children the reported mean age of poisoning was 8.5 years.…”

Section: Discussionmentioning

confidence: 75%

Aluminum phosphide poisoning in Saudi Arabia over a nine-year period

Alnasser

Hussain

Kirdi

et al. 2018

Annals of Saudi Medicine

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BACKGROUNDAluminum phosphide (AlP) is an insecticide and rodenticide used to protect stored grains from rodents and other household pests. This substance is highly toxic to humans and has been the cause of many accidental and intentional deaths due in part to poor regulation of sales and distribution in many countries.OBJECTIVESDescribe poisonings reported to the Ministry of Health in Saudi Arabia in terms of demographic variables and by time and geographic distribution.DESIGNRetrospective medical record review.SETTINGMinistry of Health hospitals nationwide.PATIENTS AND METHODSUsing a semi-structured checklist, data was collected from patient records that contained sociodemographic variables and the outcome (died or discharged).MAIN OUTCOME MEASURESAggregated data, summary statistics and statistical comparisons.SAMPLE SIZE68 patients.RESULTSThirty-eight (56%) were female and the mean (SD) age of patients was 18.6 (1.86) years. Eighteen of 22 (82%) patients who died were younger than 20 years old. Mortality in patients younger than 20 years of age was greater than in adults (P=.043). Mortality was highest in patients younger than 7 years of age (P=.006). The cases were reported by the Islamic years 1427–1435, corresponding approximately to Gregorian years 2006 to 2017. Fifty-six cases (83%) were reported from Jeddah. Most cases were due to accidental exposure to phosphine gas during fumigation.CONCLUSIONMortality due to AlP poisoning was highest in children and most commonly occurred during fumigation of households. Delays in medical attention and diagnosis may have contributed to mortality.LIMITATIONSRetrospective data collection and relatively small sample size. Data on exact amount and route of phosphide ingestion or exposure not available.

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“…Pro-inflammatory actions of Al have been reported in various tissues (Fogarty et al, 1998;Verma et al, 2007;Lerner, 2007;Exley, 2013;Taiwo, 2014;de Chambrun et al, 2014;Gherardi et al, 2016;Martinez et al, 2017;Hangouche et al, 2017). It is triggered by Al-induced oxidative stress and free radical production (Milnerowicz et al, 2015).…”

Section: Toxic Action or Effect Selected Referencesmentioning

confidence: 99%

“…Toxic myocarditis, myocardial hypokinesia, left ventricular thrombosis and myocardial dysfunction were reported in a case of Al phosphide intoxication (Hangouche et al, 2017). Ischemic stroke due to thrombosis in the right middle cerebral artery was reported as the delayed complication of Al phosphide poisoning (Abedini et al, 2014).…”

Section: Cardiovascular Effectsmentioning

confidence: 99%

Aluminium toxicosis: a review of toxic actions and effects

Igbokwe

Igwenagu

Igbokwe

2019

Interdisciplinary Toxicology

271

149

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Aluminium (Al) is frequently accessible to animal and human populations to the extent that intoxications may occur. Intake of Al is by inhalation of aerosols or particles, ingestion of food, water and medicaments, skin contact, vaccination, dialysis and infusions. Toxic actions of Al induce oxidative stress, immunologic alterations, genotoxicity, pro-inflammatory effect, peptide denaturation or transformation, enzymatic dysfunction, metabolic derangement, amyloidogenesis, membrane perturbation, iron dyshomeostasis, apoptosis, necrosis and dysplasia. The pathological conditions associated with Al toxicosis are desquamative interstitial pneumonia, pulmonary alveolar proteinosis, granulomas, granulomatosis and fibrosis, toxic myocarditis, thrombosis and ischemic stroke, granulomatous enteritis, Crohn’s disease, inflammatory bowel diseases, anemia, Alzheimer’s disease, dementia, sclerosis, autism, macrophagic myofasciitis, osteomalacia, oligospermia and infertility, hepatorenal disease, breast cancer and cyst, pancreatitis, pancreatic necrosis and diabetes mellitus. The review provides a broad overview of Al toxicosis as a background for sustained investigations of the toxicology of Al compounds of public health importance.

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Reversible Myocardial Injury and Intraventricular Thrombus Associated with Aluminium Phosphide Poisoning

Cited by 14 publications

References 13 publications

Assessment of the Role of Total Antioxidant Capacity and Troponin I as Possible Predictors for Phosphides -Induced Cardiotoxicity

Assessment of the Role of Total Antioxidant Capacity and Troponin I as Possible Predictors for Phosphides -Induced Cardiotoxicity

Aluminum phosphide poisoning in Saudi Arabia over a nine-year period

Aluminium toxicosis: a review of toxic actions and effects

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