Meggs W J, Hoffman R S, Shih R D, Weisman R S, Goldfrank L R
New York City Poison Center, New York 10016.
J Toxicol Clin Toxicol. 1994;32(6):723-30. doi: 10.3109/15563659409017979.
Four young adults presented two days after one of them had received marzipan balls packaged in a box from an expensive candy manufacturer. Two ate one candy ball, while two others shared a third. The next day, variable gastrointestinal symptoms developed. On the third day, two patients developed painful paresthesiae of the hands and feet, an early but nonspecific clinical marker of thallium poisoning. A tentative diagnosis of thallium poisoning was made based on symptoms, and treatment was initiated. The remaining candies were radiographed. Metallic densities in the candies supported the diagnosis, and atomic absorption spectroscopy was used to quantitate thallium content. Each candy contained a potentially fatal dose. Five to seven days later, hypertension and tachycardia developed in the two patients who had ingested an entire candy. All patients developed alopecia but recovered without overt neurologic or other sequelae. While the diagnosis of thallium poisoning is often delayed until alopecia develops, an early diagnosis favors an effective treatment strategy.
四名年轻人在其中一人收到一家昂贵糖果制造商用盒子包装的杏仁蛋白软糖球两天后出现症状。两人各吃了一个糖球，另外两人分吃了第三个。第二天，出现了各种胃肠道症状。第三天，两名患者出现手脚疼痛性感觉异常，这是铊中毒的早期但非特异性临床指标。根据症状初步诊断为铊中毒，并开始治疗。对剩余的糖果进行了X光检查。糖果中的金属密度支持了诊断，并使用原子吸收光谱法定量铊含量。每颗糖果都含有潜在致命剂量的铊。五到七天后，食用了一整颗糖果的两名患者出现高血压和心动过速。所有患者都出现了脱发，但康复后没有明显的神经或其他后遗症。虽然铊中毒的诊断通常会延迟到脱发出现，但早期诊断有利于采取有效的治疗策略。
