Shao Zekai, Wang Minyan, Mandizadza Oscar Onayi, Ji Conghua
School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China.
Front Public Health. 2025 Sep 10;13:1651851. doi: 10.3389/fpubh.2025.1651851. eCollection 2025.
This paper synthesizes case reports and series to outline the clinical features, diagnosis, treatment, and prognosis of cadmium poisoning. It offers structured evidence to improve understanding, early diagnosis, and clinical management, aiding healthcare professionals in prevention and intervention.
The study protocol has been registered in the PROSOPERO system (CRD420251128280). We independently searched PubMed, Scopus, and Cochrane databases using keywords including "cadmium poisoning," "case report," and "case series." Only English-language case reports and series with confirmed or highly suspected cadmium poisoning were included, up to May 2025. Animal studies, reviews, and articles lacking individual patient data were excluded. Additional references were identified from the bibliographies of retrieved articles. Study quality was assessed using the JBI tool for case reports/series.
Among the 12 included studies, there were a total of 17 patients. We found that cadmium poisoning primarily affects adult males and is often associated with occupational exposure. Common risk factors include smoking and alcohol consumption. The study also found that low iron stores exacerbate cadmium poisoning. Diagnosis relies on a combination of clinical diagnostic tests, blood and urine tests, chest X-rays, kidney ultrasounds, bone density measurements, and skeletal imaging. The treatment plan includes the use of chelating agents to reduce cadmium levels in the body and antibiotics to maintain the patient's condition. For patients with concurrent lung and kidney involvement, mechanical ventilation and continuous renal replacement therapy (CRRT) may be required. Additionally, for patients with osteochondropathy, supplementation with calcium and vitamin D is recommended. While most patients have a favorable prognosis, fatal cases due to respiratory failure or renal failure have been reported.
This review emphasizes that cadmium poisoning is rare and complex, with non- specific symptoms and a tendency to cause organ damage. Therefore, it is necessary to enhance clinical vigilance. Occupational exposure highlights the need for public health surveillance. Diagnosis relies on blood or urine cadmium testing, which is crucial for guiding treatment. Although the condition is relatively uncommon and most patients have a favorable prognosis, the risk of severe complications and mortality underscores the importance of timely and individualized treatment. Further research is needed to optimize management and improve long-term outcomes.
(registration number: CRD420251128280).
本文综合病例报告和系列病例，概述镉中毒的临床特征、诊断、治疗及预后。提供结构化证据以增进理解、早期诊断及临床管理，协助医疗专业人员进行预防和干预。
本研究方案已在PROSPERO系统（注册号：CRD420251128280）注册。我们使用包括“镉中毒”“病例报告”和“病例系列”等关键词，独立检索了PubMed、Scopus和Cochrane数据库。仅纳入截至2025年5月的确诊或高度疑似镉中毒的英文病例报告和系列病例。排除动物研究、综述及缺乏个体患者数据的文章。从检索到的文章参考文献中识别其他参考文献。使用JBI病例报告/系列病例工具评估研究质量。
在纳入的12项研究中，共有17例患者。我们发现镉中毒主要影响成年男性，且常与职业暴露有关。常见风险因素包括吸烟和饮酒。研究还发现低铁储备会加重镉中毒。诊断依赖于临床诊断检查、血液和尿液检查、胸部X线、肾脏超声、骨密度测量及骨骼成像的综合应用。治疗方案包括使用螯合剂降低体内镉水平以及使用抗生素维持患者状况。对于合并肺部和肾脏受累的患者，可能需要机械通气和连续性肾脏替代治疗（CRRT）。此外，对于患有骨软骨病的患者，建议补充钙和维生素D。虽然大多数患者预后良好，但也有因呼吸衰竭或肾衰竭导致死亡的病例报告。
本综述强调镉中毒罕见且复杂，症状不具特异性，且有导致器官损害的倾向。因此，有必要提高临床警惕性。职业暴露凸显了公共卫生监测的必要性。诊断依赖于血液或尿液镉检测，这对指导治疗至关重要。尽管该病相对不常见且大多数患者预后良好，但严重并发症和死亡风险强调了及时和个体化治疗的重要性。需要进一步研究以优化管理并改善长期预后。
（注册号：CRD420251128280）
