Zinc toxicity - Revision history

Rossdonaldson1: /* References */

2021-09-28T18:26:52Z

References

← Older revision		Revision as of 18:26, 28 September 2021
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	==References==		==References==
	<references/>		<references/>
	~~Majlesi, N. Zinc. In: Goldfrank's Toxicologic Emergencies. 9th Ed. New York: McGraw-Hill; 2011: 1339-1344~~

	[[Category:Toxicology]]		[[Category:Toxicology]]

ClaireLewis at 22:52, 2 October 2019

2019-10-02T22:52:38Z

← Older revision		Revision as of 22:52, 2 October 2019
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	*Ceruloplasmin level		*Ceruloplasmin level
	*Abdominal films to assess for foreign bodies		*Abdominal films to assess for foreign bodies
	*MRI		*[[brain MRI\|MRI]]
	**Will show increase T<sub>2</sub> signal in the dorsal columns of the cervical cord		**Will show increase T<sub>2</sub> signal in the dorsal columns of the cervical cord

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	*Oral toxicity		*Oral toxicity
	**Supportive Care		**Supportive Care
	***Hydration		***[[IVF\|Hydration]]
	***[[H2 blocker\|H<sub>2</sub> receptor antagonists]] or [[PPI]]		***[[H2 blocker\|H<sub>2</sub> receptor antagonists]] or [[PPI]]
	***[[Antiemetics]]		***[[Antiemetics]]
	**Consider whole bowel irrigation		**Consider [[whole bowel irrigation]]
	*Inhalation		*Inhalation
	**Supportive care		**Supportive care
	***[[Oxygen therapy]]		***[[Oxygen therapy]]
	***[[Bronchodilators]]		***[[Bronchodilators]]
	**Metal fume fever		**[[Metal fume fever]]
	***Usually self limiting		***Usually self limiting
	***CXR usually normal		***[[CXR]] usually normal
	*Chelation		*Chelation
	**Limited data on use, and data present is based off of case reports and treatment for lead toxicity <ref>Majlesi, N. Zinc. In: Goldfrank's Toxicologic Emergencies. 9th Ed. New York: McGraw-Hill; 2011: 1342</ref>		**Limited data on use, and data present is based off of case reports and treatment for lead toxicity <ref>Majlesi, N. Zinc. In: Goldfrank's Toxicologic Emergencies. 9th Ed. New York: McGraw-Hill; 2011: 1342</ref>

ClaireLewis: /* Clinical Features */

2019-08-27T15:23:16Z

Clinical Features

← Older revision		Revision as of 15:23, 27 August 2019
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	**Acute lung injury		**Acute lung injury
	**[[Acute Respiratory Distress Syndrome]]		**[[Acute Respiratory Distress Syndrome]]
	**Metal fume fever		**[[Metal fume fever]]

	===Chronic===		===Chronic===

ClaireLewis at 01:10, 27 January 2019

2019-01-27T01:10:38Z

← Older revision		Revision as of 01:10, 27 January 2019
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	**Rhinitis		**Rhinitis
	**[[Dyspnea]]		**[[Dyspnea]]
	**[[Acute lung injury]]		**Acute lung injury
	**[[Acute Respiratory Distress Syndrome]]		**[[Acute Respiratory Distress Syndrome]]
	**[[Metal fume fever]]		**Metal fume fever

	===Chronic===		===Chronic===
	*Zinc induced copper deficiency		*Zinc induced copper deficiency
	**Reversible [[~~sideroblastic~~ anemia]]		**Reversible sideroblastic [[anemia]]
	**Reversible [[myelodysplastic syndrome]]		**Reversible [[myelodysplastic syndrome]]
	*Progressive myeloneuropathy		*Progressive myeloneuropathy
	**Spastic gait		**Spastic gait
	**Sensory ataxia		**Sensory [[ataxia]]

	==Differential Diagnosis==		==Differential Diagnosis==
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	**Supportive Care		**Supportive Care
	***Hydration		***Hydration
	***H<sub>2</sub> receptor antagonists or PPI		***[[H2 blocker\|H<sub>2</sub> receptor antagonists]] or [[PPI]]
	***Antiemetics		***[[Antiemetics]]
	**Consider whole bowel irrigation		**Consider whole bowel irrigation
	*Inhalation		*Inhalation
	**Supportive care		**Supportive care
	***Oxygen therapy		***[[Oxygen therapy]]
	***Bronchodilators		***[[Bronchodilators]]
	**Metal fume fever		**Metal fume fever
	***Usually self limiting		***Usually self limiting
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	**Limited data on use, and data present is based off of case reports and treatment for lead toxicity <ref>Majlesi, N. Zinc. In: Goldfrank's Toxicologic Emergencies. 9th Ed. New York: McGraw-Hill; 2011: 1342</ref>		**Limited data on use, and data present is based off of case reports and treatment for lead toxicity <ref>Majlesi, N. Zinc. In: Goldfrank's Toxicologic Emergencies. 9th Ed. New York: McGraw-Hill; 2011: 1342</ref>
	**Consider in patients with hemodynamic compromise		**Consider in patients with hemodynamic compromise
	**CaNa<sub>2</sub>EDTA, British ~~anti-Lewisite~~, DTPA were all successfully used in case reports		**CaNa<sub>2</sub>[[EDTA]], [[British antilewisite]], DTPA were all successfully used in case reports
	**1000mg/m<sup>2</sup>/d IV CaNa<sub>2</sub>EDTA every 6 hours		**1000mg/m<sup>2</sup>/d IV CaNa<sub>2</sub>EDTA every 6 hours
	***Based on a successful case report, but should be given in conjunction with toxicology or poison control center		***Based on a successful case report, but should be given in conjunction with toxicology or poison control center

Rossdonaldson1: Text replacement - "Poison Control Center" to "poison control"

2018-08-13T09:03:30Z

Text replacement - "Poison Control Center" to "poison control"

← Older revision		Revision as of 09:03, 13 August 2018
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	==Disposition==		==Disposition==
	*Consult Toxicology or ~~Poison Control Center~~		*Consult Toxicology or [[poison control]]

	==References==		==References==

Rossdonaldson1: /* Differential Diagnosis */

2018-08-12T20:42:06Z

Differential Diagnosis

@@ Line 38: / Line 38: @@
 ==Differential Diagnosis==
-===[[Heavy metal]] toxicity===
+{{Heavy metals list}}
 ==Evaluation==

Rossdonaldson1: /* Acute */

2018-08-12T20:39:55Z

Acute

← Older revision		Revision as of 20:39, 12 August 2018
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	**Rhinitis		**Rhinitis
	**[[Dyspnea]]		**[[Dyspnea]]
	**[[Acute ~~Lung Injury~~]]		**[[Acute lung injury]]
	**[[Acute Respiratory Distress Syndrome]]		**[[Acute Respiratory Distress Syndrome]]
	**[[Metal fume fever]]		**[[Metal fume fever]]

Rossdonaldson1: /* Clinical Features */

2018-08-12T20:39:38Z

Clinical Features

← Older revision		Revision as of 20:39, 12 August 2018
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	==Clinical Features==		==Clinical Features==
	*'''Acute~~'''~~		===Acute===
	**GI distress		*GI distress
	***Nausea		**[[Nausea]]
	***Vomiting		**[[Vomiting]]
	***Abdominal pain		**[[Abdominal pain]]
	***GI bleeding		**[[GI bleeding]]
	***Partial and full thickness burns causing strictures with zinc chloride solutions with >20% zinc		**Partial and full thickness burns causing strictures with zinc chloride solutions with >20% zinc
	**Inhalation		*Inhalation
	***Lacrimation		**Lacrimation
	***Rhinitis		**Rhinitis
	***Dyspnea		**[[Dyspnea]]
	***[[Acute Lung Injury]]		**[[Acute Lung Injury]]
	***[[Acute Respiratory Distress Syndrome]]		**[[Acute Respiratory Distress Syndrome]]
	***[[Metal fume fever]]		**[[Metal fume fever]]
	*'''Chronic~~'''~~
	**Zinc induced copper deficiency		===Chronic===
	***Reversible [[sideroblastic anemia]]		*Zinc induced copper deficiency
	***Reversible [[myelodysplastic syndrome]]		**Reversible [[sideroblastic anemia]]
	**Progressive myeloneuropathy		**Reversible [[myelodysplastic syndrome]]
	***Spastic gait		*Progressive myeloneuropathy
	***Sensory ataxia		**Spastic gait
			**Sensory ataxia

	==Differential Diagnosis==		==Differential Diagnosis==

Rossdonaldson1 at 20:38, 12 August 2018

2018-08-12T20:38:24Z

← Older revision		Revision as of 20:38, 12 August 2018
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	*Exposure from diet, medicinal uses, nutritional supplements, and occupational exposures		*Exposure from diet, medicinal uses, nutritional supplements, and occupational exposures
	**Multiple case reports of zinc toxicity related to ingestion of United States pennies which contain 97.5% zinc		**Multiple case reports of zinc toxicity related to ingestion of United States pennies which contain 97.5% zinc
	==Toxicokinetics==
			===Toxicokinetics===
	*Absorbed primarily in the jejunum		*Absorbed primarily in the jejunum
	*Excreted via the GI tract with minimal amounts excreted in the urine		*Excreted via the GI tract with minimal amounts excreted in the urine
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	*Inverse relationship with copper		*Inverse relationship with copper
	**Excess zinc absorption will cause a counterregulatory response resulting in copper elimination		**Excess zinc absorption will cause a counterregulatory response resulting in copper elimination

	==Clinical Features==		==Clinical Features==
	*'''Acute'''		*'''Acute'''
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	***Spastic gait		***Spastic gait
	***Sensory ataxia		***Sensory ataxia

	==Differential Diagnosis==		==Differential Diagnosis==
	===[[Heavy metal]] toxicity===		===[[Heavy metal]] toxicity===
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	*[[Tin toxicity]]		*[[Tin toxicity]]
	*[[Zinc toxicity]]		*[[Zinc toxicity]]

	==Evaluation==		==Evaluation==
	*BMP		*BMP
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	*MRI		*MRI
	**Will show increase T<sub>2</sub> signal in the dorsal columns of the cervical cord		**Will show increase T<sub>2</sub> signal in the dorsal columns of the cervical cord

	==Management==		==Management==
	*Oral toxicity		*Oral toxicity
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	*Copper replacement		*Copper replacement
	**Oral copper alone shown to improve hematopoietic effects and prevent further neurological deterioration <ref> Rowin J, Lewis SL. Copper deficiency myeloneuropathy and pancytopenia secondary to overuse of zinc supplementation. J Neurol Neurosurg Psychiatry. 2005;76:750-751. </ref>		**Oral copper alone shown to improve hematopoietic effects and prevent further neurological deterioration <ref> Rowin J, Lewis SL. Copper deficiency myeloneuropathy and pancytopenia secondary to overuse of zinc supplementation. J Neurol Neurosurg Psychiatry. 2005;76:750-751. </ref>

	==Disposition==		==Disposition==
	*Consult Toxicology or Poison Control Center		*Consult Toxicology or Poison Control Center

	==References==		==References==
	<references/>		<references/>

Therriac at 00:38, 8 August 2018

2018-08-08T00:38:43Z

← Older revision		Revision as of 00:38, 8 August 2018
Line 97:		Line 97:
	<references/>		<references/>
	Majlesi, N. Zinc. In: Goldfrank's Toxicologic Emergencies. 9th Ed. New York: McGraw-Hill; 2011: 1339-1344		Majlesi, N. Zinc. In: Goldfrank's Toxicologic Emergencies. 9th Ed. New York: McGraw-Hill; 2011: 1339-1344

			[[Category:Toxicology]]