Utility of Silver Nitrate Test for Post-Mortem Diagnosis of Aluminum Phosphide Poisoning

Background: Intoxication with aluminum phosphide has been prevalent in Iran recently. Lab confirmation of the poisoning is needed in clinical and post-mortem settings. Present study was conducted to determine efficiency and validity of silver nitrate test for detection of aluminum phosphide in samples. Methods: Information about dead patients with history of aluminum phosphide poisoning referred for medicolegal autopsy was collected during 18 months. Their relationships with result of silver nitrate test was assessed statistically. Results: 24 patients were studied. Silver nitrate test on samples of intraabdominal organs was positive in 75% of autopsies, while the test on gastric content was positive in 50%. Relationship between number of ingested tablets and silver nitrate test was statistically significant (p value=0.017). Conclusion: Results of present study showed that silver nitrate test can be used as a preliminary method for evaluation of patients or dead bodies suspected to be intoxicated with ALP. However, even negative result of silver nitrate test would not preclude ALP poisoning and more definitive quantitative tests such as HS-GC should be ordered, if feasible.