Can aluminium phosphide poisoning cause hypermagnesaemia? A study of 121 patients

Aluminium phosphide (ALP) poisoning is one of the major causes of death in northern India. It is the commonest mode for suicide. The present study includes 121 patients of proven ALP poisoning. The age varied between 20 and 45 years, and the majority (95) were females. Clinical manifestations were nausea and vomiting in all the patients, dyspnoea and palpitation (78 each), cyanosis (65), hypotension (43) and shock (57). Cardiac arrhythmias were present in 96 cases and hypermagnesaemia in 51 patients. The mean serum total magnesium level (1.94 +/- 0.29 mEq/l) was significantly (p less than 0.01) elevated compared to the mean total magnesium level in control subjects (1.62 +/- 0.26 mEq/l). There was a significantly greater rise in serum magnesium in patients with severe toxicity compared to patients with mild to moderate toxicity. Out of 121 cases studied, 86 died; 76 died within 24 h of ALP ingestion. Mortality was commoner (45 out of 57) in patients with severe toxicity.