Thallium toxicity: Difference between revisions
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*Quickly oxidizes with exposure to air | *Quickly oxidizes with exposure to air | ||
==Mechanism of Toxicity== | ===Mechanism of Toxicity=== | ||
*Unknown: seems to affect various enzyme systems | *Unknown: seems to affect various enzyme systems | ||
*Lethal dose 12-15 mg/kg | *Lethal dose 12-15 mg/kg | ||
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*Chronic: | *Chronic: | ||
**2-4 weeks: peripheral neuropathy, chorea, stomatitis, hair loss | **2-4 weeks: peripheral neuropathy, chorea, stomatitis, hair loss | ||
==Differential Diagnosis== | |||
{{Heavy metals list}} | |||
==Evaluation== | ==Evaluation== | ||
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*Activated charcoal binds thallium in vitro | *Activated charcoal binds thallium in vitro | ||
*Ipecac can be given in the prehospital setting if given within first few minutes of exposure | *Ipecac can be given in the prehospital setting if given within first few minutes of exposure | ||
==Disposition== | |||
==See Also== | |||
*[[Heavy metal toxicity]] | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Toxicology]] [[Category:Environmental]] | [[Category:Toxicology]] [[Category:Environmental]] | ||
Revision as of 06:53, 10 December 2016
Background
- Soft metal used in jewelry and semiconductors
- No longer used as a rodenticide in the US
- Quickly oxidizes with exposure to air
Mechanism of Toxicity
- Unknown: seems to affect various enzyme systems
- Lethal dose 12-15 mg/kg
Clinical Features
- Acute:
- 12 hours: Abdominal pain, nausea, vomiting, diarrhea, shock
- 2-3 days: delirium, respiratory failure, seizures, death
- Chronic:
- 2-4 weeks: peripheral neuropathy, chorea, stomatitis, hair loss
Differential Diagnosis
- Aluminum toxicity
- Antimony toxicity
- Arsenic toxicity
- Barium toxicity
- Beryllium toxicity
- Bismuth toxicity
- Boron toxicity
- Cadmium toxicity
- Cesium toxicity
- Chromium toxicity
- Cobalt toxicity
- Copper toxicity
- Gold toxicity
- Iron toxicity
- Lead toxicity
- Lithium toxicity
- Manganese toxicity
- Mercury toxicity
- Nickel toxicity
- Phosphorus toxicity
- Platinum toxicity
- Selenium toxicity
- Silver toxicity
- Thallium toxicity
- Tin toxicity
- Vanadium toxicity
- Zinc toxicity
Evaluation
- Urine thallium concentration >20mcg/L indicates toxicity
- Blood levels are not considered reliable except in large exposures
- Plain films may be useful in acute ingestion because thallium is radiopaque
Management
- Prussian blue is mainstay of therapy in Europe
- Crystal lattice structure binds thallium ions, preventing enterohepatic recycling
- Activated charcoal binds thallium in vitro
- Ipecac can be given in the prehospital setting if given within first few minutes of exposure