Bonura Adriano, Siniscalchi Antonio, Crupi Domenica, Magliozzi Alessandro, Bravi Maria Cristina, Internullo Mattia, Mangiardi Marilena, Pezzella Francesca Romana, Schito Barbara, Anticoli Sabrina
Neurology, Neurophysiology and Neurobiology Unit, Department of Medicine, Università Campus Bio- Medico di Roma, Rome, Italy.
Department of Neurology and Stroke Unit, Annunziata Hospital of Cosenza, Cosenza, Italy.
Curr Med Chem. 2025;32(19):3748-3758. doi: 10.2174/0109298673313180240625070037.
Argyria is the chronic accumulation of silver in biological tissues such as skin, liver, kidneys, lungs, peripheral nerves, and brain. The presence of an actual pathophysiological and clinical correlate related to silver encephalic and peripheral nerve deposition is still much debated. In this paper, we reviewed and described case reports regarding argyria associated with neuropsychiatric symptoms in order to explain the underlying mechanism of the disease. We conducted a narrative review by searching for case reports that described subjects with chronic silver accumulation and who had associated neurological or psychiatric symptoms. Moreover, we report a case of a 50-year-old man admitted to our hospital with a diagnosis of major depression who presented with worsening psychiatric symptoms after abuse of silver-containing nasal spray. We found 15 cases of patients with argyria and neuropsychiatric manifestations such as epilepsy, neurodegenerative syndromes, multiple sclerosis, peripheral neuropathy, and psychiatric disorders. The knowledge of possible pathogenetic mechanisms and recognition of clinical features of argyria can help clinicians prevent brain deposition and its complications.
银质沉着症是银在皮肤、肝脏、肾脏、肺、周围神经和大脑等生物组织中的慢性蓄积。与银在脑和周围神经沉积相关的实际病理生理和临床关联仍存在诸多争议。在本文中，我们回顾并描述了与神经精神症状相关的银质沉着症的病例报告，以解释该疾病的潜在机制。我们通过搜索描述慢性银蓄积且伴有相关神经或精神症状的病例报告进行了叙述性综述。此外，我们报告了一例50岁男性因重度抑郁症入院，在滥用含银鼻喷雾剂后出现精神症状恶化的病例。我们发现了15例患有银质沉着症且有癫痫、神经退行性综合征、多发性硬化症、周围神经病变和精神障碍等神经精神表现的患者。了解银质沉着症可能的发病机制并认识其临床特征有助于临床医生预防脑部沉积及其并发症。
