{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T18:07:14Z","timestamp":1765994834021,"version":"3.44.0"},"reference-count":14,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,2,19]]},"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:p>A 16-year-old girl presented with grade 3 hepatic encephalopathy (HE) following suicide attempt after consuming a lethal dose of yellow phosphorus containing rodenticide. Although she was a candidate for liver transplantation, it could not be done. In the absence of a specific antidote for yellow phosphorus poisoning, the patient was managed conservatively. In addition, low volume-therapeutic plasma exchange (LV-TPE) was initiated, which resulted in a dramatic improvement in HE. Although liver transplantation is the definitive treatment, this case has shown that TPE has a promising role as a \u2018bridge to recovery\u2019 in situations where transplantation is not feasible. We describe our experience with the above-mentioned case, along with the sequence of clinical recovery and the trend in biochemical parameters during follow-up. The patient made a full recovery and is doing well.<\/jats:p>","DOI":"10.1136\/bcr-2020-239676","type":"journal-article","created":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T12:41:36Z","timestamp":1619008896000},"page":"e239676","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Plasmapheresis in lethal yellow phosphorus poisoning: a scope for recovery"],"prefix":"10.1136","volume":"14","author":[{"given":"Jithin","family":"Mathew","sequence":"first","affiliation":[{"name":"Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Gnanaraj","sequence":"additional","affiliation":[{"name":"Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8801-708X","authenticated-orcid":false,"given":"Abhishekh","family":"Basavarajegowda","sequence":"additional","affiliation":[{"name":"Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1602-5785","authenticated-orcid":false,"given":"Ramanathan","family":"Venkateswaran","sequence":"additional","affiliation":[{"name":"Medicine, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,4,21]]},"reference":[{"key":"2025082803070990000_14.4.e239676.1","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/S1665-2681(19)31799-5","article-title":"Acute liver failure due to white phosphorus ingestion","volume":"8","author":"Santos","year":"2009","journal-title":"Ann Hepatol"},{"key":"2025082803070990000_14.4.e239676.2","unstructured":"Radhika V , Narayanasamy K , Chezhian A . Rat killer poisoning vs liver damage: a view in South Indian patients of tertiary care center. J Gastroint Dig Syst 2018."},{"key":"2025082803070990000_14.4.e239676.3","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1016\/j.aohep.2019.04.008","article-title":"Current concepts in acute liver failure","volume":"18","author":"Rovegno","year":"2019","journal-title":"Ann Hepatol"},{"key":"2025082803070990000_14.4.e239676.4","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s40265-018-1018-z","article-title":"Hepatic encephalopathy: definition, clinical grading and diagnostic principles","volume":"79","author":"Weissenborn","year":"2019","journal-title":"Drugs"},{"key":"2025082803070990000_14.4.e239676.5","unstructured":"Severity Grading In Drug Induced Liver Injury . LiverTox: clinical and research information on drug-induced liver injury. Bethesda, MD, 2012."},{"key":"2025082803070990000_14.4.e239676.6","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21257"},{"key":"2025082803070990000_14.4.e239676.7","doi-asserted-by":"crossref","first-page":"29","DOI":"10.3109\/15563650.2010.547860","article-title":"White phosphorus poisoning by oral ingestion of firecrackers or little devils: current experience in Ecuador","volume":"49","author":"Gonz\u00e1lez-Andrade","year":"2011","journal-title":"Clin Toxicol"},{"key":"2025082803070990000_14.4.e239676.8","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-195012000-00001"},{"key":"2025082803070990000_14.4.e239676.9","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1002\/jca.21705","article-title":"Guidelines on the Use of Therapeutic Apheresis in Clinical Practice - Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Eighth Special Issue","volume":"34","author":"Padmanabhan","year":"2019","journal-title":"J Clin Apher"},{"key":"2025082803070990000_14.4.e239676.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.12.003"},{"key":"2025082803070990000_14.4.e239676.11","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.jhep.2015.08.018","article-title":"High-Volume plasma exchange in patients with acute liver failure: an open randomised controlled trial","volume":"64","author":"Larsen","year":"2016","journal-title":"J Hepatol"},{"key":"2025082803070990000_14.4.e239676.12","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1002\/jca.21737","article-title":"Therapeutic plasma exchange in acute liver failure","volume":"34","author":"Stahl","year":"2019","journal-title":"J Clin Apher"},{"key":"2025082803070990000_14.4.e239676.13","unstructured":"Phosphorus [MAK Value Documentation, 2007]. The MAK\u2010Collection for Occupational Health and Safety:1\u201320."},{"key":"2025082803070990000_14.4.e239676.14","unstructured":"Beuhler MC . Phosphorus. In: Nelson LS , Lewin NA , Howland MA , eds. Goldfrank\u2019s Toxicologic Emergencies. 9th ed. New York: McGraw Hill Medical, 2011: p.1440."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-239676","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:07:24Z","timestamp":1756375644000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-239676"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4]]},"references-count":14,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,4,21]]},"published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1136\/bcr-2020-239676"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-239676","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,4]]}}}