A RARE CASE OF YELLOW PHOSPHOROUS POISONING WITH ACUTE CHOLESTATIC HEPATITIS, BICYTOPENIA AND IMPENDING HEPATIC FAILURE


Shiju K. Sleeba, Midhun Raj, Pa Kabeer, Dipu K. P.

Abstract


Yellow phosphorus is a protoplasmic poison (a potent hepatotoxin). Fulminant poisoning results from ingestion of more than 1 to 2 g. An 18 y old adult male presented with ingestion of rodenticide poison containing 3 percent phosphorous in paste form. He was asymptomatic during the first day of hospitalization. He developed jaundice on the second day. On evaluation, his total leukocyte count was 1.800 (109/l) on the day of admission, which improved to 4.400 (109/l) on the 7th day. His platelet count was 1.53 (109/l) on the day of admission, which decreased daily till 0.80 (109/l) on the 7th day of hospitalization. His prothrombin time started deranging from the second day of admission with a crest of 38 s and INR 2.98 noted on the 5th day. He was given N-acetyl cysteine on the 5th day following which PT/INR began to improve and reached to a baseline normal. The regimen of N-acetyl cysteine used was a loading dose of 150 mg/kg IV over 1 h, followed by 50 mg/kg IV over 4 h and 100 mg/kg IV over 16 h. He was also treated with fresh frozen plasma and intravenous vitamin k. The man made a dramatic recovery and became stable.

Keywords: India, Kerala, Kottakkal, Phosphorous, Poisoning, N-acetyl cysteine, Hepatitis, Hepatic failure


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About this article

Title

A RARE CASE OF YELLOW PHOSPHOROUS POISONING WITH ACUTE CHOLESTATIC HEPATITIS, BICYTOPENIA AND IMPENDING HEPATIC FAILURE

Date

01-04-2016

Additional Links

Manuscript Submission

Journal

International Journal of Pharmacy and Pharmaceutical Sciences
Vol 8, Issue 4, 2016 Page: 402-403

Online ISSN

0975-1491

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114 Views | 146 Downloads

Authors & Affiliations

Shiju K. Sleeba
Department of Internal Medicine and Gastroenterology, ALMAS Hospital, Kottakkal, Malappuram 676505, Kerala, India
India

Midhun Raj

Pa Kabeer

Dipu K. P.


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