Title: A Case of Rodenticide Poisoning with Acute Fulminant Hepatic Failure: A Case Report

Authors: Dr Harshitha. R, Dr Anil Kumar. H

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i9.52

Abstract

Rodenticides are a heterogeneous group of compounds that exhibit markedly different toxicities to humans and rodents. They are among the most toxic substances regularly found in homes.  Predominant rodenticide exposure is anticoagulant rodenticides, zinc phosphide, thallium, barium carbonate and phosphorous. Ratol is a rodenticide available in most of the households and is a common suicidal or accidental poisoning. Ratol contains 3% whitephosphorous (yellow phosphorous). White phosphorous is a general protoplasmic poison causing multiorgan failure at lethal doses. Liver injury is common; however, most victims of phosphorous intoxication die before overt lesions develop. White phosphorous lethal dose for humans is around 60 mg (1mg/kg). When consumed at lethal doses patients present late (>72 hours of ingestion) with multiorgan dysfunction with high mortality rate (100%). We hereby present a 34-year-old female, came with history of alleged history of consumption of around 2g of Ratol paste 2 days prior to presenting to hospital with complains of nausea and abdominal pain. Her vitals were stable having mild scleral icterus and epigastric tenderness. Liver function tests revealed elevated bilirubin levels and deranged coagulation profile. Other parameters were normal. She was given supportive treatment. Her liver enzymes and coagulation profile improved over next 10 days.

References

  1. Aniket A Saoji, Anurag S Lavekar et al (2014) A case on suicidal poisoning associated with Ratol and a prospective on yellow phosphorous poisoning. Int. J of recent trends in Science and Technology Vol-10, Issue 2:223-225.
  2. Mauskar A, Mehta K, Nagotkar L, Shanbag P (2011) Acute hepatic failure due to YP ingestion. Indian J Pharmacol 43(3): 355–356.
  3. Modern Medical Toxicology; 4th edition; V.V. Pillay
  4. F. Fletcher, John. T. Galambos (1963) Phosphorous poisoning in Humans. Arch intern Med. 112(6): 846-852.
  5. McCarron MM, Gaddis GP, Trotter AT (1981) Acute YP poisoning from pesticide pastes. ClinToxicol 18(6):693- 711.
  6. Karanth S, Nayyar V (2003) Rodenticide-induced Hepatotoxicity. JAPI 51.

Corresponding Author

Dr Harshitha. R

RRMCH