Acute Severe Thallium Poisoning: Early Diagnosis and Treatment

Abstract

The paper considers the problems of diagnosis of severe thallium salt poisoning in early-stage intoxication, which are associated with the fact that alopecia, a clinical typical symptom of thallium toxicity, appears in the period exceeding two weeks. At the same time, in severe poisoning a fatal outcome occurs much more early and the first signs of intoxication are highly diversified and nonspecific. The clinical manifestations with no specificity at the early period of intoxication in conjunction with the absence of certain history data result in late (sometimes postmortem) diagnosis in the vast majority of cases, particularly, in criminal cases. This comprises a danger of acute severe thallium poisoning since unrecognized intoxication leads to incorrect treatment and patient death. While making a differential diagnosis, attention should be given to a set of a number of symptoms that arouse suspicion of thallium poisoning, which is an indication for chemical and analytical studies of biological environments in these patients. This paper summarizes the available data on ethyology, pathogenesis and cliniu-cal manifestations of severe thallium poisoning and demonstrate own cases of thallium intoxication occurred recently in Yaroslavl and Saint Petersburg. Basic strategy of thallium poisoning treatment is presented and discussed. Key words: acute poisoning, thallium compounds, antidote therapy, diffeferential diagnosis.