Eldad et al studied the systemic effects of phosphorus poisoning in white rats. Hepatic toxicity can lead to acute hepatic failure, which may be part of multi-organ failure. The authors are from Hadassah University Hospital in Jerusalem and the Israel Defense Force Medical Corps.
NOTE: Although described in white rats, the histologic changes would be the same in a human exposed to phosphorus.
Parameters:
(1) intercellular hemorrhage
(2) hepatocellular necrosis
(3) swelling of hepatocytes
(4) steatosis
(5) acute inflammation (neutrophilic infiltrate)
|
Parameter |
Finding |
Points |
|
hemorrhage |
none |
2 |
|
|
patchy |
1 |
|
|
diffuse and prominent |
0 |
|
hepatocellular necrosis |
none |
2 |
|
|
patchy |
1 |
|
|
diffuse |
0 |
|
swelling of hepatocytes |
none or minimal |
2 |
|
|
mild to moderate |
1 |
|
|
diffuse and marked |
0 |
|
steatosis |
none or minimal |
2 |
|
|
patchy |
1 |
|
|
diffuse and marked |
0 |
|
acute inflammation |
none |
2 |
|
|
patchy |
1 |
|
|
diffuse and prominent |
0 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The lower the score the more severe the hepatotoxicity.
Specialty: Toxicology, Emergency Medicine, Critical Care
