Iranian Red Crescent Medical Journal

Published by: Kowsar

Successful Treatment of Heart Failure Due to Simultaneous Poisoning with Aluminum Phosphide and Zinc Phosphide: A Case Report

Aliasghar Manouchehri 1 , Reza Mohseni Ahangar 1 , Pedram Bigvand 1 , Samaneh Nakhaee 2 and Omid Mehrpour 2 , *
Authors Information
1 Department of Internal Medicine, School of Medicine, Babol University of Medical Sciences, Babol, Iran
2 Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
Article information
  • Iranian Red Crescent Medical Journal: March 31, 2019, 21 (3); e57123
  • Published Online: February 26, 2018
  • Article Type: Case Report
  • Received: June 28, 2017
  • Revised: November 29, 2017
  • Accepted: February 14, 2018
  • DOI: 10.5812/ircmj.57123

To Cite: Manouchehri A, Mohseni Ahangar R, Bigvand P, Nakhaee S, Mehrpour O. Successful Treatment of Heart Failure Due to Simultaneous Poisoning with Aluminum Phosphide and Zinc Phosphide: A Case Report, Iran Red Crescent Med J. 2019 ; 21(3):e57123. doi: 10.5812/ircmj.57123.

Copyright © 2018, Iranian Red Crescent Medical Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited
1. Introduction
2. Case Presentation
3. Discussion
  • 1. Dawson AH, Eddleston M, Senarathna L, Mohamed F, Gawarammana I, Bowe SJ, et al. Acute human lethal toxicity of agricultural pesticides: a prospective cohort study. PLoS Med. 2010;7(10). e1000357. doi: 10.1371/journal.pmed.1000357. [PubMed: 21048990].
  • 2. Bumbrah GS, Krishan K, Kanchan T, Sharma M, Sodhi GS. Phosphide poisoning: a review of literature. Forensic Sci Int. 2012;214(1-3):1-6. doi: 10.1016/j.forsciint.2011.06.018. [PubMed: 21763089].
  • 3. Mehrpour O, Aghabiklooei A, Abdollahi M, Singh S. Severe hypoglycemia following acute aluminum phosphide (rice tablet) poisoning; a case report and review of the literature. Acta Med Iran. 2012;50(8):568-71. [PubMed: 23109032].
  • 4. Mehrpour O, Abdollahi M. Poison treatment centers in Iran. Hum Exp Toxicol. 2012;31(3):303-4. doi: 10.1177/0960327110392086. [PubMed: 21138986].
  • 5. Oghabian Z, Mehrpour O. Treatment of Aluminium Phosphide Poisoning with a Combination of Intravenous Glucagon, Digoxin and Antioxidant Agents. Sultan Qaboos Univ Med J. 2016;16(3):e352-5. doi: 10.18295/squmj.2016.16.03.015. [PubMed: 27606117].
  • 6. Oghabian Z, Afshar A, Rahimi HR. Hepatotoxicity due to zinc phosphide poisoning in two patients: role of N-acetylcysteine. Clin Case Rep. 2016;4(8):768-72. doi: 10.1002/ccr3.618. [PubMed: 27525081].
  • 7. Abdollahi M, Mehrpour O, Farzaneh E. Successful Treatment of Aluminum Phosphide Poisoning with Digoxin: A Case Report and Review of Literature. Intl J Pharmacol. 2011;7(7):761-4. doi: 10.3923/ijp.2011.761.764.
  • 8. Gurjar M, Baronia AK, Azim A, Sharma K. Managing aluminum phosphide poisonings. J Emerg Trauma Shock. 2011;4(3):378-84. doi: 10.4103/0974-2700.83868. [PubMed: 21887030].
  • 9. Mehrpour O, Alfred S, Shadnia S, Keyler DE, Soltaninejad K, Chalaki N, et al. Hyperglycemia in acute aluminum phosphide poisoning as a potential prognostic factor. Hum Exp Toxicol. 2008;27(7):591-5. doi: 10.1177/0960327108096382. [PubMed: 18829736].
  • 10. Soltaninejad K, Beyranvand MR, Momenzadeh SA, Shadnia S. Electrocardiographic findings and cardiac manifestations in acute aluminum phosphide poisoning. J Forensic Leg Med. 2012;19(5):291-3. doi: 10.1016/j.jflm.2012.02.005. [PubMed: 22687771].
  • 11. Yildiz M, Kocabay G, Ozkan M. Aluminium-induced ventricular tachycardia. Am J Emerg Med. 2012;30(1):262 e1-2. doi: 10.1016/j.ajem.2010.11.012. [PubMed: 21185676].
  • 12. Bashardoust B, Farzaneh E, Habibzadeh A, Seyyed Sadeghi MS. Successful treatment of severe metabolic acidosis due to acute aluminum phosphide poisoning with peritoneal dialysis: a report of 2 cases. Iran J Kidney Dis. 2017;11(2):165-7. [PubMed: 28270650].
  • 13. Mehrpour O, Amouzeshi A, Dadpour B, Oghabian Z, Zamani N, Amini S, et al. Successful treatment of cardiogenic shock with an intraaortic balloon pump following aluminium phosphide poisoning. Arh Hig Rada Toksikol. 2014;65(1):121-6. doi: 10.2478/10004-1254-65-2014-2393. [PubMed: 24445229].
  • 14. Nakhaee S, Mehrpour O, Balali-Mood M. Does N-acetyl cysteine have protective effects in acute aluminum phosphide poisoning? Indian J Crit Care Med. 2017;21(8):539-40. doi: 10.4103/ijccm.IJCCM_223_17. [PubMed: 28904489].
  • 15. Dogan E, Guzel A, Ciftci T, Aycan I, Celik F, Cetin B, et al. Zinc phosphide poisoning. Case Rep Crit Care. 2014;2014:589712. doi: 10.1155/2014/589712. [PubMed: 25101186].
  • 16. Saraf V, Pande S, Gopalakrishnan U, Balakrishnan D, Menon RN, Sudheer OV, et al. Acute liver failure due to zinc phosphide containing rodenticide poisoning: Clinical features and prognostic indicators of need for liver transplantation. Indian J Gastroenterol. 2015;34(4):325-9. doi: 10.1007/s12664-015-0583-2. [PubMed: 26310868].
  • 17. Louriz M, Dendane T, Abidi K, Madani N, Abouqal R, Zeggwagh AA. Prognostic factors of acute aluminum phosphide poisoning. Indian J Med Sci. 2009;63(6):227-34. doi: 10.4103/0019-5359.53386. [PubMed: 19602756].
  • 18. Trakulsrichai S, Kosanyawat N, Atiksawedparit P, Sriapha C, Tongpoo A, Udomsubpayakul U, et al. Clinical characteristics of zinc phosphide poisoning in Thailand. Ther Clin Risk Manag. 2017;13:335-40. doi: 10.2147/TCRM.S129610. [PubMed: 28352183].
  • 19. Sanaei-Zadeh H, Farajidana H. Is there a role for digoxin in the management of acute aluminum phosphide poisoning? Med Hypotheses. 2011;76(5):765-6. doi: 10.1016/j.mehy.2011.02.023. [PubMed: 21388748].
  • 20. Gupta MS, Malik A, Sharma VK. Cardiovascular manifestations in aluminium phosphide poisoning with special reference to echocardiographic changes. J Assoc Physicians India. 1995;43(11):773-4. 779-80. [PubMed: 8773039].
  • 21. Mehrpour O, Abdollahi M, Sharifi MD. Oxidative stress and hyperglycemia in aluminum phosphide poisoning. J Res Med Sci. 2014;19(2).
  • 22. Hassanian-Moghaddam H, Zamani N. Therapeutic role of hyperinsulinemia/euglycemia in aluminum phosphide poisoning. Medicine (Baltimore). 2016;95(31). e4349. doi: 10.1097/MD.0000000000004349. [PubMed: 27495040].
  • 23. Mehrpour O, Dolati M, Soltaninejad K, Shadnia S, Nazparvar B. Evaluation of histopathological changes in fatal aluminum phosphide poisoning. Indian J Forensic Med Toxicol. 2008;2(2):34-6.
  • 24. Erfantalab P, Soltaninejad K, Shadnia S, Zamani N, Hassanian-Moghaddam H, Mahdavinejad A, et al. Trend of blood lactate level in acute aluminum phosphide poisoning. World J Emerg Med. 2017;8(2):116-20. doi: 10.5847/wjem.j.1920-8642.2017.02.006. [PubMed: 28458755].
  • 25. Taghaddosinejad F, Farzaneh E, Ghazanfari-Nasrabad M, Eizadi-Mood N, Hajihosseini M, Mehrpour O. The effect of N-acetyl cysteine (NAC) on aluminum phosphide poisoning inducing cardiovascular toxicity: a case-control study. Springerplus. 2016;5(1):1948. doi: 10.1186/s40064-016-3630-2. [PubMed: 27917341].

Featured Image:

Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .

Search Relations:



Create Citiation Alert
via Google Reader

Readers' Comments