Zinc phosphide (Zn2P3) rodenticide, is generally misused intentionally for suicidal purpose in Iran. For many years, scientists believe that liberation of phosphine (PH3) on contact with acidic content of the stomach is responsible for clinical presentations. However, relatively long time interval between ingestion of Zn2P3and presentation of its systemic toxicity, and progression of acute liver failure could not be explained by the current opinion. Hence, an innovative theory intended that phosphonium, as an intermediate product will create and pass through the stomach, which then will reduce to produce PH3in the luminal tract. Here, we present a case of massive Zn2P3poisoning. In our case, we used repeated doses of castor oil to induce bowel movement with an aim of removing unabsorbed toxin, which was proved by radiography. Interestingly, the patient presents only mild symptoms of toxicity such as transient metabolic acidosis and hepatic dysfunction.
Marashi SM. What really happens after zinc phosphide ingestion? A debate against the current proposed mechanism of phosphine liberation in zinc phosphide poisoning. Eur Rev Med Pharmacol Sci 2015;19:4210-1.
Marashi SM. What is the real cause of hepatic dysfunction after zinc phosphide containing rodenticide poisoning? Indian J Gastroenterol 2016;35:147-8.
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;34:325-9.
Hassanian-Moghaddam H, Shahnazi M, Zamani N, Bahrami-Motlagh H. Abdominal imaging in zinc phosphide poisoning. Emerg Radiol 2014;21:329-31.
Marashi SM, Arefi M, Behnoush B, Nasrabad MG, Nasrabadi ZN. Could hydroxyethyl starch be a therapeutic option in management of acute aluminum phosphide toxicity? Med Hypotheses 2011;76:596-8.
Marashi SM, Nasri-Nasrabadi Z. Can sodium bicarbonate really help in treating metabolic acidosis caused by aluminium phosphide poisoning? Arh Hig Rada Toksikol 2015;66:83-4.
Sanaei-Zadeh H. Clinical toxicology for medical students. Unpublished educational booklet. Shiraz, Iran: Shiraz University of Medical Sciences; 2015.
Karanth S, Nayyar V. Rodenticide-induced hepatotoxicity. J Assoc Physicians India2003;51:816-7.