- Thallium poisoning: a case report
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Oscar Jimenez, Hector Cáceres, Luis Gimenez, Luciana Soto, Micaela Montenegro, Jhon Alexander Avila Rueda
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J Yeungnam Med Sci. 2023;40(3):311-314. Published online December 15, 2022
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DOI: https://doi.org/10.12701/jyms.2022.00647
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Abstract
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- Thallium poisoning is usually accidental. We present a case of a 51-year-old woman who was evaluated in June 2018 for myalgia, vertigo, asthenia, and abdominal pain. Physical examination revealed temporal-spatial disorientation, jaundice, and asterixis. The laboratory reported the following: bilirubin, 10.3 mg/dL; aspartate transaminase, 78 U/L; alanine transaminase, 194 U/L; albumin, 2.3 g/dL; prothrombin time, 40%; and platelet count, 60,000/mm3. Serology performed for hepatitis A, B, and C; Epstein-Barr virus; cytomegalovirus; and human immunodeficiency virus was negative, and a collagenogram was negative. Physical reevaluation revealed alopecia on the scalp, armpits, and eyebrows; macules on the face; plantar hyperkeratosis; and ulcers on the lower limbs. Tests for lead, arsenic, copper, and mercury were carried out, which were normal; however, elevated urinary thallium (540 µg/g; range, 0.4–10 µg/g) was observed. The patient was treated with ᴅ-penicillamine 1,000 mg/day and recovered her urinary thallium levels were within normal range at annual follow-up. Thallium poisoning is extremely rare and can be fatal in small doses. An adequate clinical approach can facilitate early diagnosis.
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Citations
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- Іmprovement of the differential diagnostics of acute oral and inhalation poisoning by thalium compounds, pathohistology and treatment strategy (based on group cases)
G.M. Balan, B.S. Sheyman, P.G. Zhminko, D.O. Dziuba, O.N. Rozhkova, N.V. Kurdil, A.H. Kudriavtseva, V.S. Lisovska, N.P. Chermnykh Ukrainian Journal of Modern Toxicological Aspects.2023; 95(2): 66. CrossRef
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