Complexions therapy and severe intoxication by Thallium salts

J Environ Sci Health A Tox Hazard Subst Environ Eng. 2021;56(4):445-453. doi: 10.1080/10934529.2021.1885905. Epub 2021 Feb 11.

Abstract

The aim of this paper is to study the clinical features of severe intoxications with thallium salts and developing effective care schemes for the application of potassium hexacyanoferrate (II) and deferasirox for correction of detected disorders. A total of 39 patients diagnosed with severe thallium salt poisoning were examined in two groups. Group I comprised 20 patients with severe thallium salt poisoning, who were prescribed with potassium-iron hexacyanoferrate in a dose of 250 mg/kg/day per os, intravenous potassium infusions, furosemide intravenously in amount of 40 mg three times per, and hemodialysis until the thallium level in the blood dropped below 10 mg/L, lactulose 30 mL two times per day per os. Group II consisted of 19 people with severe thallium salt poisoning, which in addition to the above treatment, received Deferasirox in a dosage of 500 mg two times per day per os. The clinical picture of severe poisoning with thallium salts is characterized by lesions of the gastrointestinal tract, nervous system (central and peripheral), alopecia, heart rhythm disorders, and myocardial ischemia zones. Extension of standard therapy with potassium-iron by adding hexacyanoferrate deferasirox showed better effect on thallium elimination rate and improved functional state of liver and kidneys in patients with severe thallium salt poisoning.

Keywords: deferasirox at poisoning by thallium; potassium-iron hexacyanoferrate at intoxication with thallium; severe intoxication with thallium salts; treatment of severe intoxications with thallium salts.

MeSH terms

  • Deferasirox / administration & dosage
  • Drug Therapy, Combination
  • Ferrocyanides / administration & dosage
  • Heavy Metal Poisoning / physiopathology
  • Heavy Metal Poisoning / therapy*
  • Humans
  • Infusions, Intravenous
  • Potassium / administration & dosage
  • Renal Dialysis
  • Salts / blood
  • Salts / isolation & purification
  • Salts / poisoning*
  • Thallium / blood
  • Thallium / isolation & purification
  • Thallium / poisoning*

Substances

  • Ferrocyanides
  • Salts
  • Thallium
  • hexacyanoferrate II
  • Potassium
  • Deferasirox