Thallium and arsenic poisoning in a small midwestern town

Daniel Rusyniak, R Furbee, Mark A. Kirk

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Thallium and arsenic have been used as a means of criminal poisoning. Although both manifest characteristically with peripheral neuropathies, thallium is associated with alopecia and arsenic with gastrointestinal symptoms. We describe the symptoms, physical findings, diagnostic test results, and outcomes in a group of men poisoned with thallium and arsenic. Seven patients had evidence of elevated thallium levels, and 2 patients had elevated arsenic and thallium levels. The most commonly reported symptoms included myalgias, arthralgias, paresthesias, and dysesthesias. Five patients developed alopecia. All patients with symptoms and peripheral neuropathies had characteristic blackening of their hair roots. Initially treated with dimercaptosuccinic acid, patients were switched to multiple-dose activated charcoal after testing revealed thallium poisoning. By 6 months, all patients' symptoms and peripheral neuropathies improved, but 5 patients had ongoing psychiatric problems. Thallium remains a means of criminal poisoning and should be considered in any patient with a rapidly progressing peripheral neuropathy with or without atopecia.

Original languageEnglish
Pages (from-to)307-311
Number of pages5
JournalAnnals of Emergency Medicine
Volume39
Issue number3
DOIs
StatePublished - 2002

Fingerprint

Arsenic Poisoning
Thallium
Arsenic
Peripheral Nervous System Diseases
Poisoning
Paresthesia
Alopecia
Succimer
Charcoal
Myalgia
Arthralgia
Routine Diagnostic Tests
Hair
Psychiatry

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Thallium and arsenic poisoning in a small midwestern town. / Rusyniak, Daniel; Furbee, R; Kirk, Mark A.

In: Annals of Emergency Medicine, Vol. 39, No. 3, 2002, p. 307-311.

Research output: Contribution to journalArticle

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