Acute bromate poisoning associated with renal failure and deafness presenting as hemolytic uremic syndrome

A case of bromate-induced acute renal failure (ARF) in an infant associated with hemolysis, thrombocytopenia and deafness is presented. The initial clinical and laboratory features suggested the diagnosis of hemolytic uremic syndrome (HUS). The serum bromide level was in the nontoxic range (1.2 mg/dl). However, further investigation of the ingested material revealed the toxic agent to be bromate rather than bromide. The spectrum of bromate (BrO3-) toxicity is different from bromide (Br-) and includes the induction of ARF and deafness. This combined with clinical evidence of behavioral regression and speech loss led to detection of deafness in this patient and confirmed the diagnosis of bromate toxicity.