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Plasmapheresis in lethal yellow phosphorus poisoning: a scope for recovery
  1. Jithin Mathew1,
  2. John Gnanaraj2,
  3. Abhishekh Basavarajegowda3 and
  4. Ramanathan Venkateswaran4
  1. 1Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
  2. 2Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India
  3. 3Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
  4. 4Medicine, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India
  1. Correspondence to Dr Ramanathan Venkateswaran; drvenks{at}gmail.com

Abstract

A 16-year-old girl presented with grade 3 hepatic encephalopathy (HE) following suicide attempt after consuming a lethal dose of yellow phosphorus containing rodenticide. Although she was a candidate for liver transplantation, it could not be done. In the absence of a specific antidote for yellow phosphorus poisoning, the patient was managed conservatively. In addition, low volume-therapeutic plasma exchange (LV-TPE) was initiated, which resulted in a dramatic improvement in HE. Although liver transplantation is the definitive treatment, this case has shown that TPE has a promising role as a ‘bridge to recovery’ in situations where transplantation is not feasible. We describe our experience with the above-mentioned case, along with the sequence of clinical recovery and the trend in biochemical parameters during follow-up. The patient made a full recovery and is doing well.

  • poisoning
  • intensive care

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Footnotes

  • Contributors JM treated the patient and drafted the manuscript. JG reviewed and revised the paper. AB provided edits. RV treated the patient, analysed the data, critically reviewed the paper and performed literature review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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