Jha S, Kumar R, Kumar R
Department of Neurology, Sanjay Gandhi PGIMS, Lucknow.
J Assoc Physicians India. 2006 Jan;54:53-5.
Due to involvement of multiple systems, thallium poisoning is notorious for complexity and seriousness as symptoms of toxicity are non-specific and diverse. Alopecia and painful neuropathy are its cardinal features, others being gastrointestinal disturbances, encephalopathy, tachycardia, ataxia, hepatorenal and cardiac damage etc. We report a case of thallium poisoning who presented initially with gastrointestinal symptoms and later developed neurological features (peripheral neuropathy and delirium). Various diagnoses were entertained in this case and thallium poisoning was suspected only after he developed alopecia and neuropsychosis. He made a significant recovery by conservative management in spite of delay in diagnosis. We conclude that a high level of suspicion should be kept for thallium poisoning, especially in patients with painful, peripheral neuropathy and gastrointestinal symptoms which appear earlier than alopecia, since prognosis is more rewarding with early diagnosis, leading to complete recovery.
由于铊中毒累及多个系统，其复杂性和严重性声名狼藉，因为中毒症状是非特异性且多样的。脱发和疼痛性神经病变是其主要特征，其他症状包括胃肠道紊乱、脑病、心动过速、共济失调、肝肾及心脏损害等。我们报告一例铊中毒病例，该患者最初表现为胃肠道症状，随后出现神经学特征（周围神经病变和谵妄）。该病例曾考虑过各种诊断，仅在患者出现脱发和神经精神症状后才怀疑铊中毒。尽管诊断延迟，但通过保守治疗患者仍取得了显著康复。我们得出结论，对于铊中毒应保持高度怀疑，尤其是对于那些出现疼痛性周围神经病变和胃肠道症状且早于脱发的患者，因为早期诊断预后更佳，可实现完全康复。
