Acute self-poisoning by ingestion of cadmium and barium

Extract

Introduction

Acute poisoning as a result of exposure to cadmium has increased in industrialized countries. The salts of cadmium are used as pigments and stabilizers in plastics. Of the many reported cases of acute cadmium poisoning [1–6], most resulted from inhalation exposures, and the diagnoses were based on patients’ histories and symptoms. Deliberate self-poisoning with oral cadmium is rare, and information regarding urine and blood cadmium concentrations is limited. The value of urine and blood cadmium concentrations as indicators of body burden or recent exposure remains uncertain. Previous case reports have shown even normal urinary cadmium concentrations at the time of diagnosis [2,4]. Some reports showed contradictory results—that there may be temporary elevations in urinary cadmium concentrations [3,6], but how long these elevations persist remains unclear.

Profuse diarrhoea, hypokalaemia and a history of use are clinical features, which may point to barium intoxication. To the best of our knowledge, acute self-poisoning with a combination of cadmium and barium has not been reported before. We report a case of acute cadmium and barium poisoning in a patient who presented with profuse diarrhoea, hypokalaemia, fever and thrombocytopenia after deliberately ingesting an industrial product containing cadmium and barium salts. Blood and urine cadmium concentrations were measured consecutively after exposure.