Methemoglobinemia and hemolysis are rare findings following phosphine poisoning. In this paper, a case of aluminum phosphide (AlP) poisoning complicated by methemoglobinemia and hemolysis with a successful treatment is reported. A 28-year-old male patient presented following intentional ingestion of an AlP tablet. In this case, hematuria, hemolysis and methemoglobinemia were significant events. A methemoglobin level of 46% was detected by CO-oximetry. The patient was treated with ascorbic acid and methylene blue and he also received supportive care. Two weeks after admission, the patient was discharged from the hospital. Hemolysis and methemoglobinemia may complicate the course of phosphine poisoning.
We reviewed the comments in the letter to editor and would like to thank the author for his interesting questions. The author's concern about the frequency of methemoglobinemia in acute aluminum phosphide (AlP) poisoning prompted us to search the Medline database using the terms "methemoglobinemia" and "aluminum phosphide and "poisoning" and found 4 papers in addition to our recent paper. [1][2][3][4] Of these publications, one was a study using rats and not in human, [1] 2 others were case reports, [2,3] and one was series of 48 human cases. [4] In the last paper, [4] in written by authors in our institution, most patients did not have an elevated MetHb, though there was an association between metHb concentration and death.
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