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1 Professor, Department of Medicine, Government TD Medical College, Alappuzha 2 Lecturer, Department of Medicine, Government TD Medical College, Alappuzha 3 Junior Consultant in Medicine, Department of Health Services, Kerala Corresponding Author Dr Arathi N Lecturer, Department of Medicine, Government TD Medical College, Vandanam, Alappuzha 688005 Mobile 9446724558, Email: arathi.n.iyer@gmail.com Abstract Background: Formic Acid is an industrial compound used in the coagulation of rubber latex in Kerala. Easy availability and accessibility of it makes it to be used as an agent of deliberate self harm. However, in literature, the complications of formic acid poisoning, both acute and chronic, is limited. Objective: to identify and evaluate the clinical presentations of late complications of formic acid poisoning. A secondary objective was to determine the late complications affecting the upper gastrointestinal tract, kidneys and eye. Methods: Patients who are admitted in the medical ward with history of ingestion of formic acid are interviewed during the acute phase and the clinical presentations and complications are recorded. Those who survived the acute event were followed up for a period of 6 months to look for complications, with the help of history and appropriate investigations. Results: A tatal of 129 patients who were admitted could be followed up for 6 month period. The 24% ingested formic acid with ethanol and all of them were males. At presentation, GIT, Respiratory and Renal symptoms were predominant. Metabolic acidosis was present in 68.8% of patients, of which 33.3% were dialysed. On follow up, hematuria, albuminuria, elevated urea and creatinine were the major renal complications noted. Imapaired visual acuity, impred colour vision and abnormal optic fundii were the ophthalmological complications. On endoscopic evaluation changes in esophagus and stomach were present. Conclusions: Late complications of Formic Acid ingestion are common in patients surviving the acute phase. Hence, those who survive the acute phase should be followed up to look for the development of complications. Patients with metabolic acidosis and renal impairement should be dialysed at the earliest to save lives.

A Study on Late Complications of Formic Acid Poisoning with Special Reference to Upper Gastrointestinal Tract, Kidney and Eye