successful treatment of aluminium phosphide poisoning: a case report

aluminium phosphide (alp) is used to kill rodents in grain storage. it produces phosphine gas which is toxic for mitochondria. the exact mechanism of action is unclear, but phosphine is thought to produce toxicity by blocking cytochrome-c oxidase, which inhibits oxidative phosphorylation and result in cell death. this poisoning has a high mortality, and survival is unlikely if more than 1.5 g is ingested. shock is the commonest and most important clinical feature and cause of death in phosphine poisoning. alp poisoning if not treated causes death within 24 hours, presumably due to cardiogenic shock. the high mortality is due to the rapid onset of shock, metabolic acidosis, cardiac arrhythmias and adult respiratory distress syndrome. here, a case of 27–year-old woman with intentional ingestion 2 alp tablets (6 g) is reported. she was admitted to afzalipour hospital in kerman with symptoms and signs of shock. because of refractory hypotension to crystalloid and vasopressor, we started glucagon. after 72 hours, there was no symptom and sign of shock, vital signs became stable and drugs were tapered. she was discharged to psychiatry ward 6 days after initial admission with full recovery. in conclusion, early administration of glucagon to alp poisoning patients in refractory shock may be helpful but this needs to be confirmed by further studies.