Severe Hypoglycemia Following Acute Aluminum Phosphide (Rice Tablet) Poisoning; A Case Report and Review of the Literature
Aluminum phosphide (AlP) as 3 g tablet is widely used in Iran to protect stored food grains from pests. Hyperglycemia following its ingestion has been already reported in the recent years but severe hypoglycemia is uncommon. Here, we report a 19 year old male who attempted suicide with one tablet of AlP and demonstrated severe hypoglycemia. Despite restoration of blood glucose concentration to normal, he failed to respond to supportive treatment and died. The possible mechanisms leading to severe hypoglycemia are discussed. Though severe hypoglycemia is rare following AlP poisoning, physicians managing such patients should be aware of it.
Mehrpour O, Singh S. Rice tablet poisoning: a major concern in Iranian population. Hum Exp Toxicolm2010;29(8):701-2.
Shadnia S, Sasanian G, Allami P, Hosseini A, Ranjbar A, Amini-Shirazi N, Abdollahi M. A retrospective 7-years study of aluminum phosphide poisoning in Tehran: opportunities for prevention. Hum Exp Toxicol 2009;28(4):209-13.
Shadnia S, Mehrpour O, Abdollahi M. Unintentional poisoning by phosphine released from aluminum phosphide. Hum Exp Toxicol 2008;27(1):87-9.
Proudfoot AT. Aluminium and zinc phosphide poisoning. Clin Toxicol (Phila) 2009;47(2):89-100.
Singh S, Bhalla A, Verma SK, Kaur A, Gill K. Cytochrome-c oxidase inhibition in 26 aluminum phosphide poisoned patients. Clin Toxicol (Phila) 2006;44(2):155-8.
Shadnia S, Mehrpour O, Soltaninejad K. A simplifiedacute physiology score in the prediction of acute aluminum phosphide poisoning outcome. Indian J Med Sci 2010;64(12):532-9.
Mehrpour O, Alfred S, Shadnia S, Keyler DE, Soltaninejad K, Chalaki N, Sedaghat M. Hyperglycemia in acute aluminum phosphide poisoning as a potential prognostic factor. Hum Exp Toxicol 2008;27(7):591-5.
Mehrpour O, Keyler D, Shadnia S. Comment on Aluminum and zinc phosphide poisoning. Clin Toxicol (Phila) 2009;47(8):838-9; author reply 839.
Dua R, Sunkaria A, Kumar V, Gill KD. Impaired mitochondrial energy metabolism and kinetic properties ofcytochrome oxidase following acute aluminium phosphide exposure in rat liver. Food Chem Toxicol 2010;48(1):53-60.
Chugh SN, Kishore K, Aggarwal N, Attri S. Hypoglycaemia in acute aluminium phosphide poisoning. JAssoc Physicians India 2000;48:855-6.
Mehrpour O, Abdollahi M. Poison treatment centers in Iran. Hum Exp Toxicol 2012;31(3):303-4
Singh B, Gupta S, Minocha SK, Aggarwal NM. Hypoglycaemia in aluminium phosphide poisoning. J Assoc Physicians India 1994;42(8):663.
Mehrpour O, Dolati M, Soltaninejad K, Shadnia S, Nazparvar B. Evaluation of histopathological changes in fatal aluminum phosphide poisoning. Indian J ForensicMed Toxicol 2008;2:34-6.
Singh S, Singh D, Wig N, Jit I, Sharma BK. Aluminum phosphide ingestion: a clinico-pathologic study. J Toxicol Clin Toxicol 1996;34(6):703-6.
Chugh SN, Ram S, Sharma A, Arora BB, Saini AS, Malhotra KC. Adrenocortical involvement in aluminium phosphide poisoning. Indian J Med Res 1989;90:289-94.
McCormick SD, Shrimpton JM, Carey JB, O'dea MF,Sloan KE, Moriyama S, Bjornsson BT. Repeated acute stress reduces growth rate of Atlantic salmon parr and alters plasma growth hormone, insulin-like growth factor 1 and cortisol. Aquaculture 1998;168:221-35.
Abder-Rahman H. Effect of aluminum phosphide on blood glucose level. Vet Hum Toxicol 1999;41(1):31-2.
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