Two-year follow-up of two patients after severe thallium intoxication

Pelclová, Daniela; Urban, Pavel; Ridzoň, Petr; Šenholdová, Zdeňka; Lukás, E; Diblik, Pavel; Lacina, Lukáš

doi:10.1177/0960327109106487

Cited by 51 publications

(27 citation statements)

References 18 publications

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“…129 Si may also play a role in maintaining healthy growth of hair. 131 Structure and nutrition within the hair follicle are likely to be interconnected. 131 Structure and nutrition within the hair follicle are likely to be interconnected.…”

Section: Structural Changementioning

confidence: 99%

Hair analysis as a biomonitor for toxicology, disease and health status

2011

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Hair analysis receives a large amount of academic and commercial interest for wide-ranging applications. However, in many instances, especially for elemental or 'mineral' analysis, the degree of success of analytical interpretation has been quite minimal with respect to the extent of such endeavors. In this critical review we address the questions surrounding hair analysis with specific intent of discovering what hair concentrations can actually relate to in a biogenic sense. This is done from a chemistry perspective to explain why and how elements are incorporated into hair and their meaning. This includes an overview of variables attributed to altering hair concentrations, such as age, gender, melanin content, and other less reported factors. Hair elemental concentrations are reviewed with regard to morbidity, with specific examples of disease related effects summarized. The application of hair analysis for epidemiology and etiology studies is enforced. A section is dedicated specifically to the area of population studies with regards to mercury, which highlights how endogenous and exogenous incorporation relies on species dependant metabolism and metabolic products. Many of the considerations are relevant to other areas of interest in hair analysis, such as for drug and isotopic analysis. Inclusion of a table of elemental concentrations in hair should act as a valuable reference (298 references).

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Section: Structural Changementioning

confidence: 99%

Hair analysis as a biomonitor for toxicology, disease and health status

2011

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“…Much of the existing knowledge of the toxic effects of thallium is derived from studies of individual incidents of acute thallium exposure (Zhao et al 2008; Tsai et al 2006; Pelclová et al 2009). Amongst papers published on the subject of thallium exposure, few have investigated the possibility and/or effects of low-level occupational exposure.…”

Section: Introductionmentioning

confidence: 99%

Comparison of urinary thallium levels in non-occupationally exposed people and workers

Staff

Cotton

Warren

et al. 2013

Int Arch Occup Environ Health

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PurposeTo determine a reference background urinary thallium level; to compare urinary thallium data from workers to this background level; to investigate factors affecting these levels and whether creatinine correction is appropriate.MethodsUrine samples from non-occupationally exposed people (n = 273, from 113 individuals) and workers (n = 896, from 447 individuals) were analysed for thallium by ICP-MS. A reference background level was calculated, defined as the 95th percentile value of a non-occupationally exposed population. Worker data were divided into two subsets: thallium workers (those who work directly with thallium or its compounds) and general workers; and compared to the background level. Bayesian linear mixed effects modelling was used to investigate factors affecting urinary thallium concentration and the efficacy of creatinine correction for the determination of urinary thallium.ResultsThe reference background urinary thallium level is 0.27 μmol/mol creatinine (creatinine-corrected) or 0.40 μg/l (uncorrected). Median values were 0.11 μmol/mol creatinine or 0.17 μg/l for non-occupationally exposed people, 0.12 μmol/mol creatinine or 0.20 μg/l for general workers and 0.19 μmol/mol creatinine or 0.41 μg/l for thallium workers. Variation was lower in creatinine-corrected models. Nine per cent of samples from general workers and 39 % of samples from thallium workers exceeded the creatinine-corrected background level. By 2010, 90 % of all workers had urinary thallium levels below the 95th percentile reference background level.ConclusionsUrinary thallium concentrations were higher in thallium workers than non-occupationally exposed people and general workers. Creatinine correction is appropriate.

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“…However, 4 cases reported loss of eyebrows in thallium-poisoned patients, as well as scalp alopecia [4, 6, 7, 14]. With the exception of 3 case reports, body hair, such as axillary and pubic hair, was spared or not noted [2, 7, 15]. …”

Section: Resultsmentioning

confidence: 99%

Alopecia and Associated Toxic Agents: A Systematic Review

Juhász

Chiang

et al. 2018

Skin Appendage Disord

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Importance/Objective: There are a number of toxic agents that can cause alopecia. In this review we summarize the known substances that cause alopecia as one of the clinical signs of overdose or toxicity. Evidence Review: A search was conducted using PubMed, EMBASE, and Cochrane for studies describing hair loss of any type as a result of exposure to or ingestion of a toxic agent. The search yielded 856 articles, with 47 studies included in this review. Findings: Agents with the strongest evidence of association to alopecia include thallium, mercury, selenium, and colchicine. Agents with described incidents include boric acid, arsenic, vitamin A, botulinum toxin, Podostroma cornu-damae, and the synthetic opioid MT-45. Conclusions and Relevance: Numerous toxic agents have been implicated in alopecia, and the strength of evidence behind each agent varies. Toxic levels of thallium and colchicine have long been established to cause alopecia, as compared to agents such as botulinum toxin A and synthetic recreational drugs which have less literature describing their links to alopecia and will need further investigation to characterize their relationships to hair loss. Knowledge of typical presentations of hair loss will aid in the development of a differential diagnosis for patients presenting with alopecia.

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Two-year follow-up of two patients after severe thallium intoxication

Cited by 51 publications

References 18 publications

Hair analysis as a biomonitor for toxicology, disease and health status

Hair analysis as a biomonitor for toxicology, disease and health status

Comparison of urinary thallium levels in non-occupationally exposed people and workers

Alopecia and Associated Toxic Agents: A Systematic Review

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