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Neurological rarities
Advanced thallium toxicity
  1. Henry Zou1,
  2. Simeon Zou2
  1. 1 College of Human Medicine, Michigan State University, Grand Rapids, Michigan, USA
  2. 2 Department of Neurology, Bronson Neuroscience Center, Kalamazoo, Michigan, USA
  1. Correspondence to Mr Henry Zou, Michigan State University College of Human Medicine, East Lansing, USA; zouhenry{at}msu.edu

Abstract

Thallium is a highly toxic tasteless, odourless and water-soluble metal that can be absorbed through the skin, inhaled or ingested. Due to the rarity of thallium toxicity, it is frequently misdiagnosed or the diagnosis is delayed. We report a 41-year-old male landscaper admitted for acute polyneuropathy and abdominal pain. He was treated for suspected Guillain-Barré syndrome and later autoimmune encephalopathy. However, over the next 42 days, he developed worsening muscle weakness, delirium and alopecia, and was diagnosed with thallium toxicity. After combining Prussian blue, activated charcoal and continuous venovenous haemofiltration, he improved though with neuropsychiatric and neuromuscular sequelae. We highlight the need to manage information disclosure properly and to preserve evidence, when the source of a toxin is unclear.

  • TOXICOLOGY
  • NEUROPATHY
  • HALLUCINATIONS
  • MUSCLE DISEASE

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

https://doi.org/10.1136/pn-2022-003577

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information.

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    Footnotes

    • Contributors Conceptualisation: HZ (lead), SZ (supporting). Data Curation: HZ (lead), SZ (supporting). Formal analysis: HZ (lead), SZ (supporting). Funding acquisition: not applicable. Investigation: HZ (lead), SZ (supporting). Methodology: HZ (lead), SZ (supporting). Project administration: HZ (lead), SZ (supporting). Resources: not applicable. Software: not applicable. Supervision: SZ (lead), HZ (supporting). Validation: SZ (lead), HZ (supporting). Visualisation: HZ (lead), SZ (supporting). Writing - original draft preparation: HZ (lead), SZ (supporting). Writing - review and editing: HZ (equal), SZ (equal).

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests Dr. Simeon Zou is the father of Henry Zou.

    • Provenance and peer review Not commissioned; externally peer reviewed by Robin Howard, London, UK.

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