1/5. hydrofluoric acid-induced burns and life-threatening systemic poisoning--favorable outcome after hemodialysis.BACKGROUND: skin contact with hydrofluoric acid (HF) may cause serious burns and life-threatening systemic poisoning. The use of hemodialysis in fluoride intoxication after severe dermal exposure to HF has been recommended but not reported. CASE REPORT: A 46-year-old previously healthy man had 7% of his body surface exposed to 71% HE Despite prompt management, with subsequent normalization of the serum electrolytes, recurrent ventricular fibrillation occurred. On clinical suspicion of fluoride-induced cardiotoxicity, acute hemodialysis was performed. The circulatory status stabilized and the patient fully recovered. High fluoride levels in the urine and serum were confirmed by the laboratory. DISCUSSION: There is no ultimate proof that the favorable outcome in this case was significantly attributable to the dialysis. However, most reported exposures of this magnitude have resulted in fatal poisoning. As our patient had normal serum electrolytes and no hypoxia or acidosis at the time of his arrhythmias, it was decided that all efforts should be focused on removing fluoride from his blood. The rationale for performing hemodialysis for this purpose is clear, even though such intervention is more obviously indicated in patients with renal failure. CONCLUSION: Hemodialysis may be an effective and potentially lifesaving additional treatment for severe exposure to HF when standard management has proven insufficient.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
2/5. Endemic fluorosis with spinal cord compression. A case report and review.We report a case of spinal cord compression in a Mexican immigrant due to vertebral osteosclerosis from chronic fluoride intoxication. Endemic fluorosis is acquired through drinking water. groundwater sources with high fluoride content occur worldwide. The epidemiology, metabolism, and clinical features of fluorosis are reviewed. Greater physician awareness of this entity is important to identify correctly patients with this unusual and potentially devastating clinical disorder.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
3/5. Fluoride-induced chronic renal failure.Renal fluoride toxicity in human beings is difficult to assess in the literature. Although experimental studies and research on methoxyflurane toxicity have shown frank renal damage, observations of renal insufficiency related to chronic fluoride exposure are scarce. We report a case of fluoride intoxication related to potomania of Vichy water, a highly mineralized water containing 8.5 mg/L of fluoride. Features of fluoride osteosclerosis were prominent and end-stage renal failure was present. The young age of the patient, the long duration of high fluoride intake, and the absence of other cause of renal insufficiency suggest a causal relationship between fluoride intoxication and renal failure.- - - - - - - - - - ranking = 2keywords = intoxication (Clic here for more details about this article) |
4/5. Delayed fatal hyperkalemia in a patient with acute fluoride intoxication.A 19-year-old man presented with acute fluoride poisoning. Initially his serum electrolytes were normal, but two hours later he developed ECG evidence of hyperkalemia followed by refractory ventricular fibrillation, suggesting that hyperkalemia may be important in the cardiotoxicity of acute fluoride intoxication. Treatment of fluoride-induced hyperkalemia consists of removal of fluoride from the body by dialysis, binding fluoride with aluminum or calcium, or enhancing fluoride excretion by inducing a metabolic alkalosis. Direct treatment of the hyperkalemia with glucose, insulin, and bicarbonate is ineffective. quinidine may be an effective therapy for the hyperkalemia and ventricular irritability, but is as yet untested in human beings.- - - - - - - - - - ranking = 5keywords = intoxication (Clic here for more details about this article) |
5/5. Acute fluoride poisoning leading to fatal hyperkalemia.Marked peaking of the T waves later recognized as being due to hyperkalemia was noted in a patient with acute fluoride intoxication before developing refractory ventricular fibrillation. Such T wave changes have not been previously described in fluoride intoxication and should alert one to the presence of hyperkalemia complicating this condition, the presence of which may herald the onset of lethal ventricular arrhythmias.- - - - - - - - - - ranking = 2keywords = intoxication (Clic here for more details about this article) |