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Category: Volume 10 Issue 02 February 2022
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Title: Role of Plasmapheresis in Acute Yellow Phosphorus Poisoning

Authors: Dr Aparna Jayara and Dr Pratit Samdani

 DOI: https://dx.doi.org/10.18535/jmscr/v10i2.11

Abstract

Introduction

There are three major forms of elemental Phosphorus present in environment – white, red and black. Red phosphorus causes discoloration of white phosphorus leading to formation of yellow phosphorus.1Yellow phosphorus is used in many industrial products like rodenticides, firework and fertilizers.2 Its easy availability makes it impossible to prevent and control the incidence of phosphorus poisoning. Fatal dose of yellow phosphorus is 1mg/kg.3

In our case report we are presenting a case of 41year old male who developed acute liver dysfunction due to yellow phosphorus poisoning and was well managed with plasmapheresis.

References

  1. Brent J, Wallace KL, Burkhart KK. Phosphorus. In: Brent J, Wallace KL, Burkhart KK, Phillips SD, Donovan JW, editors. Critical Care Toxicology – Diagnosis and Management of the Critically Poisoned Patient.Philadelphia, PA: Elsevier Mosby; 2005. pp. 851–61. [Google Scholar]
  2. Tenenbein M. Position statement: Whole bowel irrigation. American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists. J Toxicol Clin Toxicol 1997;35:753–62. [PubMed] [Google Scholar]
  3. Mauskar A, Mehta K, Nagotkar L, Shanbag P. Acute hepatic failure due to yellow phosphorus ingestion. Indian J Pharmacol 2011;43:355-6. [PUBMED]  [Full text]
  4. Mishra AK, Devakiruba NS, Jasmine S, Sathyendra S, Zachariah A, Iyadurai R. Clinical spectrum of yellow phosphorous poisoning in a tertiary care centre in South India: A case series. Trop Doct 2016. pii: 0049475516668986
  5. Fernandez OU, Canizares LL. Acute hepatotoxicity from ingestion of yellow phosphorus-containing fireworks. J Clin Gastroenterol 1995;21:139-42.
  6. Nalabothu M, Monigari N, Acharya R. Clinical profi le and outcomes of rodenticide poisoning in tertiary care hospital. Int J Sci Res Publ 2015; 5:1-12. Available from: http://www.ijsrp.org/research-paper-0815/ijsrp-p4442.pdf. [Last accessed on 2016 Jan 05].  
  7. Karanth S, Nayyar V. Rodenticide-induced hepatotoxicity. J Assoc Physicians India 2003;51:816-7.  [PUBMED]  
  8. Ravikanth R, Sandeep S, Phillip B, Acute Yellow Phosphorus Poisoning Causing Fulminant Hepatic Failure with Parenchymal Hemorrhages and Contained Duodenal Perforation Indian J Crit Care Med. 2017 Apr; 21(4): 238–242.
  9. Talley RC, Linhart JW, Trevino AJ, Moore L, Beller BM. Acute elemental phosphorus poisoning in man: Cardiovascular toxicity. Am Heart J. 1972;84:139–40. [PubMed] [Google Scholar]
  10. Santos O, Restrepo JC, Velasquez L, Castano J, Correa G, Sepulveda E, et al. Acute liver failure due to white phosphorus ingestion. Ann Hepatol. 2009;8:162–5. [PubMed] [Google Scholar]
  11. Marin GA, Montoya CA, Sierra JL, Senior JR. Evaluation of corticosteroid and exchange-transfusion treatment of acute yellow-phosphorus intoxication. N Engl J Med. 1971;284:125–8. [PubMed] [Google Scholar]
  12. Varghese J, Joshi V, Bollipalli MK, Malleeswaran S, Patcha R, Nair H, Vij V, Sachan D, Subramanian P, Jain M, Venkataraman J. Role of therapeutic plasma exchange in acute liver failure due to yellow phosphorus poisoning. Indian J Gastroenterol. 2020 Dec;39(6):544-549. doi: 10.1007/s12664-020-01095-y. Epub 2021 Jan 6. PMID: 33409946; PMCID: PMC7787244.
  13. Mathew J, Gnanaraj J, Basavarajegowda A, Venkateswaran R. Plasmapheresis in lethal yellow phosphorus poisoning: a scope for recovery. BMJ Case Rep. 2021 Apr 21;14(4):e239676. doi: 10.1136/bcr-2020-239676. PMID: 33883110; PMCID: PMC8061805.
  14. https://www.kireports.org/article/S2468-0249(20)30532-5/pdf cited on 18th nov 2021

Corresponding Author

Dr Aparna Jayara