Citation

Sabzi F, Heydari A, Moghaddam RH, Rouzbahani M, Asadmobini A. Acta Facultatis Medicae Naissensis 2021; 38(3): 305-310.

Copyright

(Copyright © 2021)

DOI

10.5937/afmnai38-29018

PMID

unavailable

Abstract

Aluminum phosphide, known as "rice tablet" (RT), is a common cause of suicide in adult women in Iran, with a high rate of lethal outcome. We report a patient with RT toxicity, with a complex syndrome of hepatic failure, renal failure, Brugada electrocardiography (ECG) patterns, and pleuropericardial effusion. The patient received conventional management with fluid therapy, gastric washing, activated charcoal followed by intra-aortic balloon pump insertion, inotropic drugs support, and mechanical ventilation. The unique features of our case are related to a combination of multiorgan failure with Brugada atypical ECG patterns and pleuropericardial effusion. Among the aforementioned complications, pleuropericardial effusion, ascites, and Brugada syndrome are exceedingly rare events. The patient was treated with high-dose inotropic drugs and intra-aortic balloon pump insertion. Despite tremendous management of metabolic acidosis, all efforts failed, and the patient died with sudden cardiac arrest. © 2021 Sciendo. All rights reserved.

Language: en

Keywords

adult; human; suicide; female; Poisoning; multiple organ failure; ischemic heart disease; resuscitation; case report; liver failure; anxiety; aluminum phosphide; kidney failure; vomiting; clinical article; hydrocortisone; drug intoxication; hospital admission; tachycardia; unclassified drug; physical examination; activated carbon; cyanosis; restlessness; drug megadose; artificial ventilation; glyceryl trinitrate; drug toxicity; alanine aminotransferase; aspartate aminotransferase; creatinine; creatinine blood level; metabolic acidosis; electrocardiography; Aluminium phosphide; thorax pain; heparin; urea nitrogen blood level; amylase; amylase blood level; inotropic agent; oxygen saturation; respiratory distress; Article; heart left ventricle ejection fraction; hypokinesia; transthoracic echocardiography; alanine aminotransferase blood level; aspartate aminotransferase blood level; allopathy; arterial pressure; Brugada syndrome; cardiogenic shock; ascites; pulse pressure; pericardial effusion; alkaline phosphatase blood level; pleura effusion; alkaline phosphatase; Ringer lactate solution; sudden cardiac death; fraction of inspired oxygen; interventricular septum; rice tablet