Attempted Self-Harm with Elemental Thallium Purchased Online: Case Report with Analytical Confirmation
Anthony Spadaro1,2, Andrew Sae Young Lee3, Hilda Pineda4
1Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA. Avs156@njms.rutgers.edu.
Summary
This case report details a rare instance of elemental thallium ingestion, a highly toxic metal, where the patient recovered after treatment with Prussian blue. Further research is needed to understand elemental thallium toxicity compared to thallium salts.
Area of Science:
- Toxicology
- Environmental Health
- Clinical Medicine
Background:
- Thallium is a highly toxic metal, with most documented poisonings involving thallium salts.
- Elemental thallium ingestion is a rare toxicological exposure with limited clinical data.
Observation:
- An 18-year-old male intentionally ingested elemental thallium purchased online.
- Elevated serum and urine thallium concentrations were measured.
- A metal fragment was removed via colonoscopy; analysis confirmed 87.0% elemental thallium.
Findings:
- The patient received Prussian blue treatment starting on hospital day 2.
- Serum thallium levels decreased from 423.5 mcg/L to 4.5 mcg/L within 29 days.
- Despite high initial concentrations, the patient showed no signs of thallium toxicity.
Implications:
- This case highlights the importance of considering elemental thallium in overdose investigations.
- Prussian blue may be effective in treating elemental thallium exposure.
- More research is required to differentiate the clinical effects and management of elemental thallium versus thallium salt poisoning.
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