Frequency of Macroscopic and Microscopic Findings from Autopsy in the Deceased Caused by Poisoning with Aluminum Phosphide, Zinc Phosphide and Super Warfarin Rodenticides

Poisoning with super-warfarin, zinc phosphide (ZnP) and aluminum phosphide (ALP) are among the most common poisonings with rodenticides. The purpose of this study was to investigate the frequency of macroscopic and microscopic findings obtained from autopsy in the deceased due to poisoning with these rodenticide poisons.

This cross-sectional study was conducted in 2020 in Isfahan Forensic Medical Center and referral poisoning emergency center in Khorshid Hospital, Isfahan, Iran. The autopsy and pathological findings in the deceased cases due to phosphides and super warfarin poisoning from 21 March 2018 to 20 Feb 2021 were evaluated.

During the study period, 165 patients were hospitalized due to super warfarin and ZnP; and 105 patients with ALP poisoning. Death ‎due to super warfarin was not reported. One patient died due to ZnP poisoning who did not undergo autopsy. 37(35.2%) people died from ALP of which 33 cases underwent postmortem examination. 24 (72.7%) of the deceased were men. And the average age was 29.39 years. In the autopsy findings, pulmonary edema (69.6%) and pleural effusion (21.2%) were the most common findings in ALP poisoning. The pathological findings were liver degeneration, pulmonary edema, and pulmonary hemorrhage. There was a significant relationship between serum bicarbonate on admission and liver autopsy finding. Also time from ingestion to hospital admission was correlated with liver pathology finding.

Considering the prevalence of pulmonary edema and pleural effusion in deceased patients with ALP, guiding fluid therapy by controlling central venous pressure should be considered.