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July 1959, Vol 98, No. 1 >
Article | July 1959

Thallium Poisoning:  Report of Two Cases FREE

MICHEL D. STEIN, M.D.; MEYER A. PERLSTEIN, M. D.
[+] Author Affiliations

Submitted for publication Dec. 18, 1958.


AMA Am J Dis Child. 1959;98(1):80-85. doi:10.1001/archpedi.1959.02070020082010.
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A survey of the admissions to the Cook County Hospital, Chicago, for the five-year period from 1954 to 1958 reveals that in a total of 396,220 admissions (excluding psychiatric cases) only two cases of thallium poisoning were recognized. While thallium poisoning is not common, neither is it so rare that it should be seen only twice in 396,000 admissions to a hospital catering to the less privileged classes. This suggests that its clinical manifestations are at times confusing and that it may simulate other conditions. The suspected diagnosis can be confirmed only by biochemical analysis. It is not the purpose of this paper to review the literature regarding thallium poisoning, but rather to add two patients whose presenting sign was ataxia. We wish to point out the salient features and the possible sources of diagnostic confusion and to report on the use of dimercaprol (BAL) and trihexyphenidyl (Artane) in therapy

REFERENCES

1 +
Grossman, H.:  Thallotoxicosis: Report of a Case and a Review , Pediatrics 16:868-872, 1956;.
2 +
Munch, J. C.:  Human Thallotoxicosis , J.A.M.A. 102:1929, 1934;.
3 +
Munch, J. C.; Ginsburg, H. M., and Nixon, C. E.:  The 1932 Thallotoxicosis Outbreak in California , J.A.M.A. 100:1315, 1933;.
4 +
 Thallotoxicosis: A Recurring Problem, Report of Council on Drugs , J.A.M.A. 165:1566, 1957;.
5 +
Heyroth, F. F.:  Thallium: A Review and Summary of Medical Literature, Supp. 197 , Public Health Rep. , 1947;.
6 +
Mazzei, E. S., and Schaposnik, F.:  Subacute Poisoning by Thallium Treated with BAL , Brit. M. J. 2:791, 1949;.
7 +
Chamberlain, P. N.; Stavinoha, W. B.; Davis, H.; Kniker, W. T., and Panos, T. C.:  Thallium Poisoning , Pediatrics 22:1170, 1958;.
8 +
Pardo-Costello, V.; Mestre, J. J., and Rio, E.:  Tinea of the Scalp: Treatment with Thallium Salts , Arch. Dermat. & Syph. 19:409, 1929;.
9 +
McCarthy, L.: Diagnosis and Treatment of Diseases of the Hair , St. Louis, The C. V. Mosby Company, 1940;.
10 +
Munch, J. C.:  The Toxicity of Thallous Sulfate , J. Am. Pharm. A. 17:1086, 1928;.
11 +
Furmanski, A. R.:  BAL Therapy of Severe Peripheral Neuropathies , Arch. Neurol. & Psychiat. 60:270, 1948;.
12 +
Longcope, W. T., and Luetscher, J. A., Jr.:  Use of BAL (British Anti-Lewisite) in Treatment of Injurious Effects of Arsenic, Mercury and Other Metallic Poisons , Advances Int. Med. 31: 545, 1949;.
13 +
Grulee, C. G., Jr., and Clark, E. H.:  Thallotoxicosis in a Preschool Nursery , Am. J. Dis. Child. 81:47, 1951;.
14 +
Fairweather, M. J.; Stovell, V.; Santiago, P.; Adams, K. P.; Davis, J., and Campbell, W.:  Thallium Poisoning of Children in Texas , Tex. J. Med. 51:466, 1955;.
15 +
Modell, W.; Gold, H., and Cattell, M.:  Pharmacological Observations on BAL by Intramuscular Injection in Man , J. Clin. Invest. 25: 480, 1946;.
16 +
Sulzberger, M. B.; Baer, R. L., and Kanof, A.:  Studies on the Toxicity of BAL on Percutaneous and Parenteral Administration , J. Clin. Invest. 25:474, 1946;.
17 +
Ellenbogen, B. K.:  Artane in the Treatment of Parkinsonism , Lancet 1:1034, 1950;.
18 +
Ferguson, F. R., and Liversedge, L. A.:  Current Therapeutics: XXXIV. The Management of Parkinsonism and Allied Extrapyramidal Diseases , Practitioner 165:437, 1950;.
19 +
Corbin, K. B.:  Trihexyphenidyl: Evaluation of the New Agent in the Treatment of Parkinsonism , J. A. M. A. 141:377, 1949;.
20 +
Bredemann, W.:  Zur histopathologie der Thalliumvergiftung im Bereich des Nervensystems , Arch. Psychiat. 192:393, 1954;.

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References

1 +
Grossman, H.:  Thallotoxicosis: Report of a Case and a Review , Pediatrics 16:868-872, 1956;.
2 +
Munch, J. C.:  Human Thallotoxicosis , J.A.M.A. 102:1929, 1934;.
3 +
Munch, J. C.; Ginsburg, H. M., and Nixon, C. E.:  The 1932 Thallotoxicosis Outbreak in California , J.A.M.A. 100:1315, 1933;.
4 +
 Thallotoxicosis: A Recurring Problem, Report of Council on Drugs , J.A.M.A. 165:1566, 1957;.
5 +
Heyroth, F. F.:  Thallium: A Review and Summary of Medical Literature, Supp. 197 , Public Health Rep. , 1947;.
6 +
Mazzei, E. S., and Schaposnik, F.:  Subacute Poisoning by Thallium Treated with BAL , Brit. M. J. 2:791, 1949;.
7 +
Chamberlain, P. N.; Stavinoha, W. B.; Davis, H.; Kniker, W. T., and Panos, T. C.:  Thallium Poisoning , Pediatrics 22:1170, 1958;.
8 +
Pardo-Costello, V.; Mestre, J. J., and Rio, E.:  Tinea of the Scalp: Treatment with Thallium Salts , Arch. Dermat. & Syph. 19:409, 1929;.
9 +
McCarthy, L.: Diagnosis and Treatment of Diseases of the Hair , St. Louis, The C. V. Mosby Company, 1940;.
10 +
Munch, J. C.:  The Toxicity of Thallous Sulfate , J. Am. Pharm. A. 17:1086, 1928;.
11 +
Furmanski, A. R.:  BAL Therapy of Severe Peripheral Neuropathies , Arch. Neurol. & Psychiat. 60:270, 1948;.
12 +
Longcope, W. T., and Luetscher, J. A., Jr.:  Use of BAL (British Anti-Lewisite) in Treatment of Injurious Effects of Arsenic, Mercury and Other Metallic Poisons , Advances Int. Med. 31: 545, 1949;.
13 +
Grulee, C. G., Jr., and Clark, E. H.:  Thallotoxicosis in a Preschool Nursery , Am. J. Dis. Child. 81:47, 1951;.
14 +
Fairweather, M. J.; Stovell, V.; Santiago, P.; Adams, K. P.; Davis, J., and Campbell, W.:  Thallium Poisoning of Children in Texas , Tex. J. Med. 51:466, 1955;.
15 +
Modell, W.; Gold, H., and Cattell, M.:  Pharmacological Observations on BAL by Intramuscular Injection in Man , J. Clin. Invest. 25: 480, 1946;.
16 +
Sulzberger, M. B.; Baer, R. L., and Kanof, A.:  Studies on the Toxicity of BAL on Percutaneous and Parenteral Administration , J. Clin. Invest. 25:474, 1946;.
17 +
Ellenbogen, B. K.:  Artane in the Treatment of Parkinsonism , Lancet 1:1034, 1950;.
18 +
Ferguson, F. R., and Liversedge, L. A.:  Current Therapeutics: XXXIV. The Management of Parkinsonism and Allied Extrapyramidal Diseases , Practitioner 165:437, 1950;.
19 +
Corbin, K. B.:  Trihexyphenidyl: Evaluation of the New Agent in the Treatment of Parkinsonism , J. A. M. A. 141:377, 1949;.
20 +
Bredemann, W.:  Zur histopathologie der Thalliumvergiftung im Bereich des Nervensystems , Arch. Psychiat. 192:393, 1954;.

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