Basheer Aneesh, Mookkappan Sudhagar, Padhi Somanath, Iqbal Nayyar
Department of General Medicine, Pondicherry Institute of Medical Sciences, Pondicherry, India.
Department of Pathology, Pondicherry Institute of Medical Sciences, Pondicherry, India.
Australas Med J. 2015 Jan 31;8(1):19-23. doi: 10.4066/AMJ.2015.2241. eCollection 2015.
Toxicity from accidental and intentional ingestion of yellow phosphorus, ubiquitously present in fireworks and rodenticides, has recently become more frequent. Gastrointestinal, renal, neurologic, and cardiovascular manifestations are common, with mortality of 23 per cent to 73 per cent. Reports of haematological abnormalities are rare. We report only the second case of severe neutropenia secondary to selective myelosuppression in a 14-year-old girl following intentional ingestion of yellow phosphorus. Leucocyte counts recovered spontaneously without further complications. Our case indicates that, besides hepatic and renal function monitoring, physicians should meticulously monitor blood counts in such cases for early detection of marrow suppression. Further studies are required to elucidate the complex mechanisms and significance of this unusual toxicity of yellow phosphorus.
意外和故意摄入烟花及灭鼠剂中普遍存在的黄磷所导致的中毒情况,近来愈发常见。胃肠道、肾脏、神经及心血管方面的表现较为常见,死亡率在23%至73%之间。血液学异常的报告较为罕见。我们报告了仅有的第二例严重中性粒细胞减少症,该病例发生在一名14岁女孩故意摄入黄磷后,继发选择性骨髓抑制。白细胞计数自发恢复,未出现进一步并发症。我们的病例表明,在此类病例中,除了监测肝肾功能外,医生还应仔细监测血细胞计数,以便早期发现骨髓抑制。需要进一步研究以阐明黄磷这种特殊毒性的复杂机制及意义。