Clinical manifestations and management of thallium poisoning in a single family with 6 cases
10.3760/cma.j.issn.1006-7876.2011.04.007
- VernacularTitle:急慢性铊中毒一家六例临床特点及治疗
- Author:
Chunnuan CHEN
;
Jinsha HUANG
;
Nian XIONG
;
Zhentao ZHANG
;
Yunping CHEN
;
Xuebing CAO
;
Tao WANG
- Publication Type:Journal Article
- Keywords:
Thallium;
Poisoning;
Neuritis;
Alopecia;
Ferrocyanides;
Hemoperfusion
- From:
Chinese Journal of Neurology
2011;44(4):252-256
- CountryChina
- Language:Chinese
-
Abstract:
Objective To further investigate clinical manifestations and management for thallium poisoning. Methods Clinical data of 6 patients who were hospitalized in Union Hospital of Tongji Medical College in May 2008 with diagnosis of acute or chronic thallium poisoning,were retrospectively analyzed.Results Six patients (4 male and 2 female) ,aged from 12 to 50,came from one family (two sisters with their husbands and sons). Five of them (3 acute and 2 chronic,for the second time in half a year,thallium poisoning) initiated with peripheral neuritis,represented with severe burning pain,numbness,paresthesia in the lower limbs,accompanied with or without gastrointestinal symptoms. A 12 year-old boy with obviously elevated urinary thallium concentration was asymptomatic. Blood and urinary thallium concentrations of the patients were determined by atomic absorption spectrophotometry and were all significantly elevated.Treatment was initiated using potassium supplementation,diuresis,oral laxatives,Prussian blue and intramuscular injection of dimercaptopropansulfonate sodium.Meanwhile two of them were treated with hemoperfusion. Finally,two of them recovered,another two were transferred to a specialized hospital for continuous treatment,and the rest two deteriorated rapidly with occurrence of unconsciousness and died of multiple organ failure. Conclusions The main clinical manifestations of thallium poisoning are multiple peripheral neuritis,gastrointestinal symptoms and dermatological changes. In order to avoid missed diagnosis and misdiagnosis,a high suspicion should be arose for thallium poisoning when a patient suffering from the above symptoms.Prussian blue was considered traditionally as an effective therapeutic strategy for the condition,and hemoperfusion may be a more effective treatment for acute thallium poisoning.
