Rodenticide ingestion is an important cause of acute hepatotoxicity in Tamil Nadu, southern India

Govindarajan, Ramkumar; Ramamoorthy, Ganesan; Shanmugam, Revathy Marimuthu; Bavanandam, Sumathi; Manimaran, M.; Shanmugam, Chitra; Aravind, Arumugam; Chellamuthu, Vaishnavi Priyaa; Venkatraj, Rajalakshmi Kandasamy; Sampathkumar, Kavitha; Rejoice, Poppy; Kumar, Kandasamy Alias; Adamali, Shafique; Kannan, Mariappan; Rathnavel, Ramani; Manivasagam, Vijai Shankar Chidambara; Velusamy, Arulselvan; Arumugam, Senthilvadivu; Elikkottil, Thasneem Taj; Dev, Anand; Sen, Mousumi; Palaniappan, Alagammai; Dorairaj, Allwin James; Kedarisetty, Chandan Kumar; Venkataraman, Jayanthi; Karthikeyan, Mugilan; Arumugam, Somasundaram; Ramakrishnan, Arulraj; Madesh, Vijaya Prakash; Varghese, Joy; Anupa, Dheeraj Kumar; Leelakrishnan, Venkatakrishnan; Swaminathan, Mukundan; Kantamaneni, Ravindra; Dhus, Jeyaraj Ubal; Murugan, N.; Natarajan, Kartik; Selvi, Caroline; Saithanyamurthi, Hemamala; Nadaraj, Ambily; Jeyaseelan, Lakshmanan; Eapen, C E

doi:10.1007/s12664-021-01178-4

Cited by 21 publications

(5 citation statements)

References 16 publications

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“…1 Among 450 patients with rat poison ingestion, 57% had ALF, with mortality in one-third. 11 This study also suggested a promising role of standard volume plasma exchange in these cases.…”

Section: Other Causesmentioning

confidence: 56%

Acute Liver Failure: Indian Perspective

Acharya

2021

Clinical Liver Disease

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Acute liver failure (ALF) is an infrequent, unpredictable clinical sequela of acute liver injury (ALI) in an individual without any previous history of liver disease and is associated with a mortality rate of 50% to 75%. 1 Encephalopathy subsequent to ALI (icterus) is the usual presentation in ALF, and coagulopathy (international normalized ratio [INR] >1.5) is frequent. 1 The etiology of ALF is geographically distinct with varying icterus-encephalopathy interval (IEI), from 4 weeks in India to 26 weeks in the United States. 2 In the United Kingdom, United States, and Europe, ALF etiology is heterogenous (paracetamol, nonsteroidal anti-inflammatory drugs [NSAIDs], autoimmune hepatitis [AIH], and metabolic diseases). 2 In India, ALF has a homogeneous etiology (hepatitis virus in 90%). 1,2 Etiology influences phenotypic presentation.In the United Kingdom, Japan, and France, ALF with IEI of 1 week or 10 days had significantly higher survival than with IEI of longer than 1 week or 10 days, leading to subclassification in ALF as hyperacute (IEI ≤ 7 days), acute (IEI > 7 days to ≤4 weeks), and subacute (IEI of 5 to ≤12 weeks). 3 In India, as a result of homogenous etiology, rapidity of encephalopathy does not influence survival, and all ALF cases have IEI of ≤4 weeks. Therefore, the Indian National Association for the Study of Liver (INASL) consensus in ALF defines it "as a clinical syndrome characterized by encephalopathy, jaundice, and prolonged prothrombin time

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“…1 Among 450 patients with rat poison ingestion, 57% had ALF, with mortality in one-third. 11 This study also suggested a promising role of standard volume plasma exchange in these cases.…”

Section: Other Causesmentioning

confidence: 56%

Acute Liver Failure: Indian Perspective

Acharya

2021

Clinical Liver Disease

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“…Acute liver injury/failure is predominantly caused by paracetamol overdose in the West; in contrast, this is mostly caused by hepatitis E in northern India and rodenticide ingestion in southern India 71 , 72 , 73 , 74 . Raised plasma VWF levels correlate with disease severity and predict in - hospital survival in patients with rodenticide induced hepatotoxicity, suggesting that innate immune activation may contribute to pathogenesis of rodenticidal hepatotoxicity 75 .…”

Section: How Does the Host Immune System Respond To A Virus Or A Drug Not Encountered Before?mentioning

confidence: 99%

Recognizing Dysfunctional Innate and Adaptive Immune Responses Contributing to Liver Damage in Patients With Cirrhosis

Goel

Eapen

2022

Journal of Clinical and Experimental Hepatology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Yellow phosphorus, used as the active ingredient in many commercially available rodenticides, can lead to hepatotoxicity and is a common cause of acute liver failure in south India. 1,2 In absence of a specific antidote, the role of therapeutic plasma exchange (PLEX) is fast expanding, with recent studies reporting successful use of low-volume (PLEX-LV) in these patients. 3,4 It is postulated that PLEX works by removing inflammatory plasma debris, especially macromolecules (e.g.…”

Section: Introductionmentioning

confidence: 99%

Reticuloendothelial activation and phenotypic alteration of peripheral monocytes with enhanced liver recruitment drive liver injury secondary to yellow phosphorus

Vijayalekshmi

Choudhary

Alexander

et al. 2023

J of Gastro and Hepatol

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Author contributions: BV, SP, AS, CE, and AG contributed to the study concept and design. AS recruited the patients and obtained informed consent. BV, VA, and AS were involved in data collection. BV, AC, and SP performed the laboratory experiments. SP, KB, UZ, CE, and AG contributed to the interpretation and conclusion. BV, AC, SP, CE, and AG were involved in the preparation of manuscript. All authors contributed to the critical revision and review of manuscript and approved the final version of the manuscript. Ethical approval: The study was cleared by the Institutional Review Board (IRB min 12129 dated 24.7.2019). Informed consent was obtained from the patients.

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Rodenticide ingestion is an important cause of acute hepatotoxicity in Tamil Nadu, southern India

Cited by 21 publications

References 16 publications

Acute Liver Failure: Indian Perspective

Acute Liver Failure: Indian Perspective

Recognizing Dysfunctional Innate and Adaptive Immune Responses Contributing to Liver Damage in Patients With Cirrhosis

Reticuloendothelial activation and phenotypic alteration of peripheral monocytes with enhanced liver recruitment drive liver injury secondary to yellow phosphorus

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