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Brain involvement in generalized argyria.

H W Dietl, A P Anzil, P Mehraein

    Clinical Neuropathology
    |January 1, 1984
    PubMed
    Summary
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    Cutaneous argyria, a condition caused by silver exposure, was diagnosed in a patient who also developed psychosis. Autopsy revealed widespread silver deposits in the brain, associated with glial changes.

    Area of Science:

    • Neurology
    • Toxicology
    • Pathology

    Background:

    • Cutaneous argyria is a condition resulting from chronic silver exposure, leading to characteristic skin discoloration.
    • The potential neurological effects of systemic silver deposition are not fully understood.

    Observation:

    • A 59-year-old woman diagnosed with cutaneous argyria also developed manic depressive psychosis.
    • The patient died six years later from a ruptured aortic aneurysm.

    Findings:

    • Autopsy revealed silver deposits in the skin, mucous membranes, heart, kidney, liver, and central nervous system.
    • Silver granules were observed in the leptomeninges, choroid plexuses, and walls of intraparenchymal vessels, particularly in the basal ganglia, hypothalamus, substantia nigra, and cerebellum.
    • Electron microscopy confirmed silver deposition in basal membranes of the choroid plexus and intracerebral vasculature, as well as within lysosomal bodies in brain parenchymal cells.

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  • Progressive glial changes and cellular gliosis were evident in multiple brain regions.

    • Implications:

    • This case highlights the potential for widespread silver deposition in the central nervous system following cutaneous argyria.
    • The findings suggest a possible link between systemic silver accumulation and neurological alterations, including glial changes.
    • Further research is warranted to elucidate the mechanisms of silver neurotoxicity and its clinical significance.