Niehues R, Horstkotte D, Klein R M, Kühl U, Kutkuhn B, Hort W, Iffland R, Strauer B E
Abteilung für Kardiologie, Pneumologie und Angiologie, Universität Düsseldorf.
Dtsch Med Wochenschr. 1995 Mar 24;120(12):403-8. doi: 10.1055/s-2008-1055360.
30 minutes after drinking half a cup of rat poison a 16-year-old girl was admitted to hospital. In addition to various enteric detoxification measures forced dialysis was instituted and, after the urinary thallium level had become known (9 mg/l), haemodialysis was begun and ferric ferrocyanide (Prussian blue) administered (0.5 mg daily for six days). She had no symptoms at any time. After 10 days she was discharged. Five days after discharge she was again admitted, with colic-like abdominal pain, vomiting, paraesthesias of the hands and feet, and in a state of agitation. She had once again ingested rat poison, about one cup. Physical examination revealed little of consequence, except diffuse alopecia. Urinary thallium concentration was 37 mg/l. In the electrocardiogram the P-R interval was shortened to 0.11 s and T waves inverted in leads III and V1. Electronmicroscopy of cardiac and skeletal biopsies revealed lipid droplets, increased sarcoplasm and widening of some of the tubules. Treatment consisted of haemodialysis, forced diuresis (1 l urine/h), administration of ferric ferrocyanide, orthograde intestinal infusions and potassium substitution (serum level: 5 mmol/l). After 28 days the patient was discharged into psychiatric care.
一名16岁女孩饮用半杯鼠药30分钟后入院。除采取各种肠道解毒措施外，还进行了强制透析，在得知尿铊水平（9毫克/升）后，开始进行血液透析并给予铁氰化铁（普鲁士蓝）（每日0.5毫克，共6天）。她在任何时候都没有症状。10天后出院。出院5天后，她再次入院，伴有绞痛样腹痛、呕吐、手足感觉异常以及烦躁不安。她又一次摄入了大约一杯鼠药。体格检查除弥漫性脱发外，未发现其他重要异常。尿铊浓度为37毫克/升。心电图显示P-R间期缩短至0.11秒，Ⅲ导联和V1导联T波倒置。心脏和骨骼肌活检的电子显微镜检查显示有脂滴、肌浆增加以及部分小管增宽。治疗包括血液透析、强制利尿（每小时1升尿液）、给予铁氰化铁、顺行性肠道灌洗以及补钾（血清水平：5毫摩尔/升）。28天后，患者出院接受精神科护理。
