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[Thallium poisoning a clinical analysis of 5 cases]
1Department of Neurology, Beijing Union Medical College Hospital, Chinese Academy of Medical Sciences.
Objective:
To sumarize the clinical features, diagnosis and treatment of thallium poisoning by analysis of clinical cases.
Methods:
Five cases of thallium poisoning were reported. The clinical manifestations, quantitative-analysed thallium level, methods and effect of treatment, and prognosis were analysed.
Results:
Three of the 5 cases were acute, and the other two chronic. Four of them had a history of poison contact. The clinical features included alopicia (4 cases), transverse white stripes in the nails (Mee's stripes, 2) polyneuropathy, cranial nerve and central nervous system impairments (5), and abdominal pain and other digestion disturbances (3). All of the 5 cases were treated with antidotes and other methods to increase thallium excretion. One case died of lung infection 3 days after diagnosis. The serum and urine thallium levels of the 4 survivors decreased to normal after treatment (3 recovered, one had neurologic sequelae).
Conclusion:
It is not difficult to diagnose thallium poisoning by definite poison contact history, classical manifestation, and serum or urine thallium quantitative analysis. Attention should be paid to those patients with indefinite exposure to thallium. For those suspected cases, it is necessary to measure the thallium level in blood and urine in order to verify the diagnosis.