Effect of Aluminium Phosphide Poisoning on Blood Cortisol Level

• Main Authors: Fariba Farnaghi, Haleh Talaie, Zahra Pournasiri, Roksana Sadeghi, Hamid Owliaey, Hossein Hassanian-Moghaddam, Shahin Shadnia
• Format: Article
• Language: English
• Published: Arak University of Medical Sciences 2013-02-01
• Series: Iranian Journal of Toxicology
• Subjects: Adrenal Insufficiency; Aluminum Phosphide; Cortisol; Poisoning; Shock
• Online Access: http://ijt.arakmu.ac.ir/browse.php?a_id=174&slc_lang=en&sid=1&ftxt=1

Background: Acute intoxication with ALP is extremely lethal. The present study was conducted to determine the range of serum cortisol levels in ALP poisoning and its correlation with patient outcome. Methods: This study was carried out on patients who were intoxicated with ALP. Their demographic data and pertinent findings in their history and physical examination were recorded at the time of arrival and also when shock and severe metabolic acidosis emerged. 5cc blood was taken from the patients to measure blood cortisol level, when shock and severe metabolic acidosis developed. Blood cortisol level analysis was performed using ELISA method. Data analysis was done using SPSS software version 16.0. Results: The average ingested dose was 1.98+1.79 tablets each containing 3 grams of ALP. Overall, 77% of the patients presented tachycardia and hypotension. Blood cortisol level less than 15 µg/dl, 15-33 µg/dl, and more than 34 µg/dl were regarded as adrenal insufficiency, critical illness-related corticosteroid insufficiency, and adequate adrenal response, respectively. Eventually, 3 patients fell within the first category, 24 patients matched with the second category, and 3 patients corresponded to the last category. Conclusion: Blood cortisol concentration is satisfactory only in 10% of the patients. In majority of the patients although it is not apparently low, it has not shown the expected rise comparable to the shock and stress state of such patients. It defines a role for corticosteroids therapy in management of ALP poisoning, particularly if it does not respond to conventional treatments.