ROLE OF THERAPEUTIC PLASMA EXCHANGE IN YELLOW PHOSPHOROUS POISONING – A SINGLE CENTRE RETROSPECTIVE STUDY FROM SOUTH INDIA

VAIDESH G.; PRATHIBA E. N.; SHANTHINI GILDA V.; RAVISHANKAR J.

doi:10.22159/ijcpr.2025v17i6.7083

Authors

VAIDESH G. Department of Immunohematology and Blood Transfusion, Government Thoothukudi Medical College, Thoothukudi, Tamilnadu, India
PRATHIBA E. N. Department of Immunohematology and Blood Transfusion, Government Thoothukudi Medical College, Thoothukudi, Tamilnadu, India
SHANTHINI GILDA V. Department of Immunohematology and Blood Transfusion, Government Thoothukudi Medical Colle
RAVISHANKAR J. Department of Immunohematology and Blood Transfusion, Government Thoothukudi Medical College, Thoothukudi, Tamilnadu, India https://orcid.org/0000-0002-2702-8658

DOI:

https://doi.org/10.22159/ijcpr.2025v17i6.7083

Keywords:

Acute liver failure, Therapeutic plasma exchange, Yellow phosphorus

Abstract

Objective: Yellow phosphorus, a rodenticide, is used as a suicidal agent that causes hepatotoxicity and acute liver failure (ALF) with increased mortality. The only definitive management is liver transplantation. Therapeutic plasma exchange (TPE) could alleviate the symptoms of yellow phosphorus by removing the poison and its metabolite from the body. Aim of this study was to determine the role and effectiveness of Therapeutic plasma exchange in yellow phosphorus poisoning.

Methods: This was a retrospective observational study conducted from January 2023 to December 2024. The study included patients who developed ALF due to yellow phosphorus poisoning requiring TPE. Patient demographic details, clinical features, quantity of consumption and laboratory values before and after TPE were noted. Statistical analysis was performed with Microsoft excel.

Results: 12 patients (M: F=2:1) who developed ALF, due to yellow phosphorus poisoning, were included for analysis. A total of 30 TPE sessions were performed (Mean=2.5 sessions). Mean age group of the patients was 29.3 years. Nine patients (75 %, M: F – 3.5:1) had recovery from ALF, out of which six had consumed<10 gm of yellow phosphorus. Among patients who recovered, mean time to admission was 2.8 days and mean time for initiation of TPE was 3.5 days. Three patients failed to show recovery and expired.

Conclusion: This study revealed that the patient outcomes were better with earlier initiation of TPE, but was also dependent on factors such as the quantity of poison consumed and time of hospitalization. Thus, TPE could potentially bridge the gap between medical management and liver transplantation in cases of yellow phosphorus poisoning.

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