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Connective tissue disease features after thallium poisoning.

D Alarcón-Segovia1, M C Amigo, P A Reyes

  • 1Department of Immunology and Rheumatology, Instituto Nacional de la Nutrición Salvador Zubirán, Mexico.

The Journal of Rheumatology
|February 1, 1989
PubMed
Summary

Thallium poisoning can mimic systemic lupus erythematosus (SLE) and other connective tissue diseases, presenting with varied symptoms and antibody profiles. These cases highlight previously unrecorded associations between thallium toxicity and autoimmune conditions.

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Area of Science:

  • Toxicology
  • Rheumatology
  • Immunology

Background:

  • Thallium poisoning is a rare condition with diverse clinical manifestations.
  • Connective tissue diseases, such as systemic lupus erythematosus (SLE), share overlapping symptoms with various toxic exposures.
  • The potential for thallium poisoning to mimic SLE has been suggested but not extensively documented.

Purpose of the Study:

  • To describe five cases where thallium poisoning presented with features mimicking or triggering connective tissue diseases.
  • To document novel associations between thallium toxicity and specific autoimmune manifestations.

Main Methods:

  • Case series presentation of five patients with confirmed thallium poisoning.
  • Detailed clinical, serological (antinuclear antibodies, rheumatoid factor), and immunological assessments were performed.

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  • Follow-up evaluations documented disease progression and resolution.

    • Main Results:

    • Case 1: Thallium poisoning mimicked SLE with positive antinuclear antibodies.
    • Case 2: A SLE-like illness with positive autoantibodies progressed to chronic polyarthritis.
    • Cases 3-5: Thallium poisoning presented with negative autoantibodies, mimicking SLE, or triggered SLE onset with glomerulonephritis, or led to keratoconjunctivitis sicca.

    Conclusions:

    • Thallium poisoning can present with a wide spectrum of clinical and serological findings overlapping with connective tissue diseases.
    • These cases expand the known differential diagnosis of SLE and related disorders to include thallium toxicity.
    • Clinicians should consider thallium poisoning in patients with unexplained autoimmune-like symptoms, particularly when serological markers are inconsistent or atypical.