Author ORCID Identifier
https://orcid.org/0009-0007-4884-6346
https://orcid.org/0000-0001-5549-2864
Abstract
Yellow phosphorus is a highly toxic compound commonly used in rodenticides and is associated with significant morbidity and mortality following ingestion. Toxicity typically evolves through an initial gastrointestinal phase, a deceptive latent period, and a final phase characterized by fulminant hepatic failure and multiorgan dysfunction. We report the case of an 18-year-old male who intentionally ingested two tubes of Ratol containing 3% yellow phosphorus. After initial vomiting and transient clinical stability, he developed rapidly progressive acute liver failure with severe coagulopathy, conjugated hyperbilirubinemia, hepatic encephalopathy, acute pancreatitis, pancytopenia, acute kidney injury, metabolic derangements, and recurrent hypoglycemia. Serial laboratory trends demonstrated explosive hepatocellular injury, early loss of hepatic synthetic function, rising serum ammonia, and progressive cytopenias. Despite aggressive intensive care management and four cycles of plasma exchange, the patient deteriorated into refractory multiorgan failure and died on day seven of hospitalization. This case underscores the catastrophic systemic toxicity of yellow phosphorus and highlights the importance of early recognition, close biochemical monitoring, and timely consideration of advanced liver support and transplantation in severe poisoning.
Publication Date
2026
Publisher
JSS Academy of Higher Education & Research
Conflict of Interest
None
Keywords
Yellow phosphorus, Ratol poisoning, acute liver failure, plasma exchange, multiorgan dysfunction, acute pancreatitis, pancytopenia, toxic hepatitis
Word Count
1364
Recommended Citation
Vunnam V, B.S S.
Limitations of Plasma Exchange in Yellow Phosphorus-Induced Acute Liver Failure: A Case Report.
Digital Journal of Clinical Medicine.
2026;
8(1):
-.
doi:
https://doi.org/10.55691/2582-3868.1305
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