Kurosaki K, Nakamura T, Mukai T, Endo T
Department of Legal Medicine, School of Medicine, Chiba University, Japan.
Forensic Sci Int. 1995 Aug 28;75(1):57-65. doi: 10.1016/0379-0738(95)01767-d.
An interesting case of acute poisoning by chromate compounds is reported. A 51-year-old man committed suicide by ingesting a fatal dose of sodium chromate solution. He unexpectedly lost consciousness 6 h after the ingestion and died approximately 20.5 h later. An examination of the blood showed noticeable hepatic damage and thrombocytopenia. The postmortem examination revealed extensive bleeding in the alimentary tract and a severe hepatic lesion due to hepatocellular necrosis. However, the renal disorder was unusually light in the microscopic and clinical findings. Moreover, the renal lesion was observed mainly in the distal tubules instead of the proximal tubules which is more typical in cases of acute poisonings by diverse heavy metals including chromium. The patient's death was assumed to have been caused by circulatory collapse due to internal bleeding and the direct toxicity of chromate compounds with hepatic malfunction and possibly disseminated intravascular coagulation (DIC).
报告了一例有趣的铬酸盐化合物急性中毒病例。一名51岁男子摄入致命剂量的铬酸钠溶液自杀。他在摄入后6小时意外失去意识，约20.5小时后死亡。血液检查显示有明显的肝损伤和血小板减少。尸检发现消化道广泛出血以及由于肝细胞坏死导致的严重肝脏病变。然而，在显微镜检查和临床检查结果中，肾脏病变异常轻微。此外，肾脏病变主要见于远端小管，而非近端小管，而在包括铬在内的多种重金属急性中毒病例中，近端小管病变更为典型。患者的死亡被认为是由于内出血导致的循环衰竭以及铬酸盐化合物的直接毒性，伴有肝功能障碍，可能还有弥散性血管内凝血（DIC）。
