Rangel-Guerra R, Martínez H R, Villarreal H J
Servicio de Neurología, Hospital Universitario, Universidad de Nuevo León.
Gac Med Mex. 1990 Nov-Dec;126(6):487-94; discussion 494-5.
We have studied fifty cases of thallium intoxication during the past nine years. Twenty-eight occurred in women and twenty-two in men. One of the patients was a new born whose mother had this type of intoxication during her third trimester of pregnancy. The ages varied from one day to 84 years and in all cases the source of thallium was ingestion of rat poison, except for the baby who received it across the placenta and an other patient whose source was transdermal. Twenty-three of the cases of intoxication were accidental, twenty-one were suicidal attempts and five were homicidal. One case did not know the source of intoxication. Thallium levels were measured in the urine of all the patients, some were measured in blood, as well as cerebrospinal fluid. The main clinical manifestation was a mixed type of severe peripheral neuropathy, with abdominal pain, nausea, vomiting and alopecia and some cases had psychiatric manifestations. Electrophysiological studies and nerve biopsy examined with electron microscopy in three patients. Magnetic nuclear resonance, computerized axial tomography of the abdomen and cranium were performed in two patients. There was only one death and the rest of the patients recovered almost completely. Pathophysiology and pharmacological management of this type of neurointoxication are revised.
在过去九年中，我们研究了五十例铊中毒病例。其中二十八例为女性，二十二例为男性。有一名患者是新生儿，其母亲在妊娠晚期出现了这种类型的中毒。患者年龄从一天到84岁不等，除了通过胎盘接触铊的婴儿和另一名经皮接触铊的患者外，所有病例中铊的来源均为摄入杀鼠药。其中二十三例中毒为意外，二十一是自杀未遂，五例为他杀。有一例患者不知道中毒源。对所有患者的尿液进行了铊含量检测，部分患者还检测了血液以及脑脊液中的铊含量。主要临床表现为混合型严重周围神经病变，伴有腹痛、恶心、呕吐和脱发，部分病例有精神症状。对三名患者进行了电生理研究以及神经活检的电子显微镜检查。对两名患者进行了腹部和头颅的磁共振成像、计算机断层扫描。仅有一例死亡，其余患者几乎完全康复。本文对这种类型的神经中毒的病理生理学和药物治疗进行了综述。
