Polyserositis: An Unusual Complication of Aluminum Phosphide Poisoning

• Main Authors: Ashish Bhalla, Sushil Mahi, Navneet Sharma, Surjit Singh
• Format: Article
• Language: English
• Published: Mashhad University of Medical Sciences 2012-12-01
• Series: Asia Pacific Journal of Medical Toxicology
• Subjects: Systemic capillary leak syndrome; Endothelial dysfunction; Phosphine gas; Aluminum Phosphide; Polyserositis
• Online Access: http://apjmt.mums.ac.ir/pdf_34_9b8f1d296ed25f3a4c14943325fdc06c.html

  Background: Aluminum phosphide is the common cause of poisoning in adults in India, with a very high case fatality ratio. We studied five patients of aluminum phosphide poisoning with polyserositis. Methods: We enrolled all patients with aluminum phosphide poisoning presenting to emergency medical department, at a tertiary care hospital in northwestern India from January to July 2006. These patients were managed according to a standard treatment protocol and their complications were recorded. Results: During the study period, total of 35 patients were admitted with 57.5% mortality in the first 12 hours. Among the rest, 5 patients were found to develop polyserositis. All these patients had severe hypotension at presentation and developed respiratory distress requiring mechanical ventilation after an average stay of 3.8 days post-ingestion. They were managed conservatively and four of them were discharged from the hospital after the average stay of 10 days. Conclusion: In this case series, features of polyserositis (pleural effusion, ascites and pericardial effusion) were found in 15% patients of severe aluminum phosphide poisoning. We postulate systemic capillary leak syndrome, secondary to mitochondrial damage in the endothelium, as a possible mechanism.