![]() ![]() ![]() Thallium deposition therefore occurs primarily in tissues with high potassium concentrations such as neuronal, myocardial, hepatic, renal, and dermal tissues. After absorption, thallium distributes widely to multiple organs with a distribution pattern similar to that of potassium ions, which have a similar atomic radius to thallium. Thallium and its salts are corrosive to the gastrointestinal mucosa, leading to abdominal pain, intestinal fluid secretion, diarrhea, and vomiting. PathophysiologyĪlthough ingestion is the most common route of exposure thallium may also be absorbed by inhalation or skin penetration. The CDC concluded that numerous common substances, such as detergents, might give rise to false-positive results on qualitative colorimetric atomic spectroscopy. Confirmatory samples of blood and urine were analyzed for thallium content at the CDC’s laboratories, and were considered by CDC to be within normal limits for thallium (0-5 mcg/L). The Government Laboratory of Guyana had been confirming thallium poisonings with a qualitative, colorimetric atomic absorption spectrometer because the laboratory’s quantitative atomic absorption equipment was inoperable. In 1987, the CDC conducted an epidemiologic investigation of a striking increase in the number of reported cases of presumed acute and chronic thallium intoxication in Georgetown, Guyana. However, the majority of environmental exposures are unlikely to lead to thallium toxicity. Most unintentional exposures in the United States are environmental through inhalation of workplace air in industries that use thallium, smoking cigarettes, and living near hazardous waste sites containing thallium. ![]() Such exposures may result in chronic thallium poisonings. Plants, fish, and shellfish harvested near thallium-producing facilities may accumulate thallium from the soil and from runoff. Thallium enters the environment primarily from coal-burning power plants, smelters, and cement factories. A few countries, such as Russia and China, continue to use thallium commercially as a rat poison. What was the oral antidote? How does it work?Ĭommercial and consumer use of thallium as a rodenticide or insecticide was banned in the United States and most other countries by 1975.Why did hair loss take so long to occur after acute exposure to thallium?.When he walked to the bathroom to brush his hair, his noted several clumps of hair in his hairbrush. By day 10, the patient was able to walk without assistance. The patient’s mental status began to normalize and other symptoms improved very slowly each day as he continued on the oral antidote. Urine thallium level was noted to be 1285 mcg/L. He was started on an oral antidote every six hours, and underwent two 4-hour runs of hemodialysis. During a period of lucidity, he disclosed that he ingested a large amount of illegal rat poison from the “Old Soviet Union.” Thallium toxicity was suspected and he was prepared for hemodialysis. On Day 2, the patient continued with severe pain, discomfort, weakness, waxing-and-waning lethargy, and confusion. Complete blood count and serum electrolytes were found to be within normal limits. ![]() Urinalysis revealed trace urine protein and specific gravity of 1.020. Electrocardiogram revealed intermittent runs of supraventricular tachycardia. During this time, he had over 10 episodes of diarrhea, and became slightly confused, and moderately diaphoretic. The next day, he developed a feeling of “pins and needles” in the lower extremities, followed by pain, burning sensations, and weakness in both upper and lower distal extremities over the next 12 hours. He had clinical signs of dehydration and laboratory evidence of fluid depletion and was admitted overnight for treatment of dehydration. Case presentationĪ 26-year-old man developed nausea, abdominal cramping, and mildly bloody diarrhea, 9 hours after a suicidal ingestion of illegally imported rat poison. Thallium is a well-known poison cited in numerous works of fictional literature, but is also a popular real-life agent of murder with worldwide homicidal usage documented since the 1800s. Thallium is a tasteless, odorless, and extremely potent poison – acute ingestions of as little as one gram of thallium salt may kill an adult. Today, medicinal use is limited to trace amounts of radioactive thallium for nuclear imaging. Thallium is a metal with a storied history of medicinal and commercial applications as a depilatory, syphilis remedy, rodenticide, ant killer, and in the manufacturing of photocells and semiconductors. Thallium was accidentally discovered in 1861 by Sir William Crookes, who noted an unexpected green banding on colorimetric spectroscopy, while researching tellurium ore (Greek, thallos: “green young shoot”). ![]()
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