Successful management of zinc phosphide poisoning: possible benefit of virgin olive oil

Metal phosphides in general and zinc phosphide, in particular, are potent insecticides and rodenticides. These are commercially used for protection of crops during storage, as well as during transportation. However, these are highly toxic substances. Zinc phosphide (Zn2P3) and other phosphides are generally misused intentionally for suicidal purpose in Turkey. While most fatal PH3 exposures are unintentional, metal phosphide pellet ingestion has been used intentionally as a means of suicide in several Asian countries and in Europe. Once ingested, zinc phosphide is decomposed into highly toxic phosphine gas by the action of a dilute hydrochloric acid content of the stomach. Phosphine acts as a respiratory poison. Even 20:100,000 part of phosphine in the air is reported to fatal. Their detrimental effects may range from nausea and headache to renal failure and death. It's poisoning has a high mortality and recent years have seen an increase in the number of poisoning cases and deaths caused by suicidal ingestion. In episodes of metal phosphide poisoning, the treatment depends on the route of exposure. We aimed to present an intentionally ingested Zn2P3 of 15 g patient on suicide purpose and our therapy with orally NaHCO3, activated charcoal and virgin olive oil. In our case, we used repeated doses of virgin olive oil to induce antioxidant activity beside the recommended therapy regimens. Interestingly, the patient presented only mild symptoms of toxicity such as transient metabolic acidosis and hepatic dysfunction

___

1. Mehrpour O. Comment on “ An update on toxicology of aluminum phosphide .” Daru. 2012;20(1):50.

2. Lauterbach M, Solak E, Kaes J, Wiechelt J, Von Mach M-A, Weilemann LS. Epidemiology of hydrogen phosphide exposures in humans reported to the poison center in Mainz, Germany, 1983– 2003. Clin Toxicol. 2005;43(6):575-81.

3. Saraf V, Pande S, Gopalakrishnan U, Balakrishnan D, Menon RN, Sudheer O V, Dhar P, Sudhindran S. Acute liver failure due to zinc phosphide containing rodenticide poisoning: Clinical features and prognostic indicators of need for liver transplantation. Indian J Gastroenterol. 2015;34(4):325-9.

4. Sciuto AM, Wong BJ, Martens ME, HoardFruchey H, Perkins MW. Phosphine toxicity: a story of disrupted mitochondrial metabolism. Ann N Y Acad Sci. 2016;1374(1):41-51.

5. Altintop I, Kaynak MF. A race against time in lethal aluminum phosphide intoxication: a case report. Med-Science. 2016; 5(Supplement 1): 143-5.

6. Kashi KP, Chefurka W. The effect of phosphine on the absorption and circular dichroic spectra of cytochrome c and cytochrome oxidase. Pestic Biochem Physiol. 1976;6(4):350-62.

7. Paiva-Martins F, Fernandes J, Santos V, Silva L, Borges F, Rocha S, Belo L, Santos-Silva A. Powerful protective role of 3,4- dihydroxyphenylethanol-elenolic acid dialdehyde against erythrocyte oxidative-Lnduced hemolysis. J Agric Food Chem. 2010;58(1):135-40.

8. Fitó M, de la Torre R, Covas M-I. Olive oil and oxidative stress. Mol Nutr Food Res. 2007;51(10):1215-24.

9. Manna C, Galletti P, Cucciolla V, Montedoro G, Zappia V. Olive oil hydroxytyrosol protects human erythrocytes against oxidative damages. J Nutr Biochem. 1999;10(3):159-65.

10. Owen RW, Giacosa A, Hull WE, Haubner R, Spiegelhalder B, Bartsch H. The antioxidant/anticancer potential of phenolic compounds isolated from olive oil. Eur J Cancer. 2000;36(10):1235-47.

11. Bendini A, Cerretani L, Carrasco-Pancorbo A, Gómez-Caravaca AM, Segura-Carretero A, Fernández-Gutiérrez A, Lercker G. Phenolic molecules in virgin olive oils: a survey of their sensory properties, health effects, antioxidant activity and analytical methods. An overview of the last decade Alessandra. Molecules. 2007;12(8):1679-719.

12. Franco MN, Galeano-Díaz T, López Ó, Fernández-Bolaños JG, Sánchez J, De Miguel C, Gil MV, Martín-Vertedor D. Phenolic compounds and antioxidant capacity of virgin olive oil. Food Chem. 2014;163:289-98.

13. Karanth S, Nayyar V. Rodenticide-induced hepatotoxicity. J Assoc Physicians India. 2003;51:816-7.

14. Hsu C-H, Chi B-C, Liu M-Y, Li J-H, Chen C-J, Chen R-Y. Phosphine-induced oxidative damage in rats: role of glutathione. Toxicology. 2002;179(1):1-8.

15. Chugh SN, Kolley T, Kakkar R, Chugh K, Sharma A. A critical evaluation of anti-peroxidant effect of intravenous magnesium in acute aluminium phosphide poisoning. Magnes Res [Internet]. 1997;10(3):225-30.
Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )
Sayıdaki Diğer Makaleler

Psychological resilience and health perception among adolescents and related factors

EMİNE ELA KÜÇÜK

Assessment of clinical diagnosis, age, gender and seasonal differences of children admitting to a dermatology clinic of a secondary health care institution

MEHMET KAYHAN, Ahmet MAMUR

Cerebral venous thrombosis occurring during oxymetholone therapy

Gokce Pinar REİS, Ayşenur BAHADIR, Erol ERDURAN, Tülay KAMAŞAK, İlker EYÜBOĞLU

The impact of gender on spouse preference in university students

SERMİN TİMUR TAŞHAN, Zekeriya ÇALIŞKAN, GÜLÇİN NACAR, Ilksen Orhan ERGİN

Assessing the effectiveness of alcohol and drug abuse awareness campaigns among University students in Kenya: A quasi-experimental study

Grace Wambura MBUTHİA, Peter WANZALA, Caroline NGUGİ, Henry NYAMOGOBA

Assessment of the use of complementary and alternative medicine with respect to illness perception among individuals with chronic diseases

EMİNE ELA KÜÇÜK

Anterior cervical discectomy and fusion solely with peek cages ın multilevel cervical spondylotic radiculomyelopathy: single center clinical experience with 58 consecutive patients

Hakan ŞİMŞEK

Distribution and evaluation of primary bone and soft tissue tumors admitted from Malatya province and surrounding provinces

REŞİT SEVİMLİ

The role of hyponatremia in preeclampsia

Erdinç SARIDOĞAN, Ayşe KIRBAŞ, Burak ELMAS, Turhan ÇAĞLAR

Distal symmetrical polyneuropathy due to organophosphate intoxication

Semih ALAY, MEHMET GÜNEY ŞENOL, Tansel KENDİRLİ, RİFAT ERDEM TOĞROL, Mehmet SARAÇOĞLU