Document Type : Case Report


1 Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Department of Nephrology, Shahid Beheshti University, Loghman-Hakim Hospital, Tehran, Iran.

3 Toxicology Research Center, Excellence Center of Clinical Toxicology AND Department of Clinical Toxicology, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 Toxicological Research Center, Department of Clinical Toxicology, Shahid Beheshti University of Medical Sciences, Loghman Hakim Hospital, Tehran, Iran.

5 Shahid Beheshti University of Medical Sciences


Introduction: Aluminum phosphide (AlP) is an effective fumigant and rodenticide which is a commonly used agent for suicide in parts of developing countries. AlP poisoning results in serious manifestations involving many vital organs and it has high mortality. Electrolyte and metabolic abnormalities including metabolic acidosis is a common problem in AlP poisoning. 
Case report: Here, we report two cases of AlP poisoning who take AlP tablets intentionally. The therapeutic intervention initiated for both of them including glucose, insulin, and potassium (GIK) protocol, antioxidants agents, intravenous magnesium, intravenous calcium, and norepinephrine. The arterial blood samples obtained in a serial manner and interestingly it showed no abnormality.
Conclusion: This is first cases of AlP poisoning with normal acid base balance which emphasis the importance the early initiation of therapeutic intervention


1. Shadnia S, Soltaninejad K. Spontaneous ignition due to intentional acute aluminum phosphide poisoning. The Journal of emergency medicine. 2011;40(2):179-81.
2. Shadnia S, Sasanian G, Allami P, Hosseini A, Ranjbar A, Amini-Shirazi N, et al. A retrospective 7-years study of 
aluminum phosphide poisoning in Tehran: opportunities for prevention. Human & experimental toxicology. 
3. Gurjar M, Baronia AK, Azim A, Sharma K. Managing aluminum phosphide poisonings. J Emerg Trauma Shock. 
4. Chugh SN, Arora V, Sharma A, Chugh K. Free radical scavengers & lipid peroxidation in acute aluminium phosphide 
poisoning. The Indian journal of medical research. 1996;104:190-3.
5. Hsu CH, Chi BC, Liu MY, Li JH, Chen CJ, Chen RY. Phosphine-induced oxidative damage in rats: role of 
glutathione. Toxicology. 2002;179(1-2):1-8.
6. Proudfoot AT. Aluminium and zinc phosphide poisoning. Clinical toxicology (Philadelphia, Pa). 2009;47(2):89-
7. Singh RB, Rastogi SS, Singh DS. Cardiovascular manifestations of aluminium phosphide intoxication. The 
Journal of the Association of Physicians of India. 1989;37(9):590-2.
8. Easterwood L, Chaffin MK, Marsh PS, Porter B, Barr C. Phosphine intoxication following oral exposure of horses to 
aluminum phosphide-treated feed. Journal of the American Veterinary Medical Association. 2010;236(4):446-50.
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. Human & experimental toxicology. 2008;27(7):591-5.
10. Ramadan N. Aluminum phosphide poisoning; a case of survival. Asia Pacific Journal of Medical Toxicology. 
11. Ghasemi Tousi A. Successful Treatment of Aluminium Phosphide, is it possible? Asia Pacific Journal of Medical 
Toxicology. 2017;6(3):90-6.