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Article: Serum ceruloplasmin monitoring in a case of silver intoxication due to intravenous silver infusion

TitleSerum ceruloplasmin monitoring in a case of silver intoxication due to intravenous silver infusion
Authors
KeywordsSilver poisoning / intoxication
Hypoceruloplasminemia
Neurotoxicity
Wilson disease
Deranged liver function
Issue Date2021
PublisherTaylor & Francis Inc. The Journal's web site is located at http://www.tandfonline.com/ictx
Citation
Clinical Toxicology, 2021 How to Cite?
AbstractIntroduction: Colloidal silver packaged as a dietary supplement is readily available online and is thought to be safe. Literature describing its toxicity in humans is scarce. Case report: A 47-year-old man presented to us for sensory and gait problems. He had unremarkable past health except dystrophic nails. He further volunteered a history of receiving chronic oral and intravenous administration of colloidal silver. We confirmed his plasma silver was 1200-fold elevated, measuring 11990 nmol/L (normal < 10 nmol/L). He had deranged liver function tests, and liver biopsy showed distorted acinar architecture, bridging fibrosis and lymphocytic infiltrate with silver particles clustering along the vascular endothelium and portal venules. Brain magnetic resonance imagining showed features of mineralization over bilateral globus pallidi. There was biochemical evidence of central adrenal insufficiency, intracellular iron overload and hypoceruloplasminemia (<0.05 g/L). Gradual clinical and biochemical improvement was noted after silver cessation: his plasma silver dropped to 4800 nmol/L (3 months) and 1650 nmol/L (12 months), and serum ceruloplasmin reverted to 0.13 g/L (10 months) and 0.29 g/L (20 months). Conclusions: The potential effects of silver to liver and copper metabolism were shown in this case. Serum ceruloplasmin also serves as a surrogate marker in monitoring silver intoxication.
Persistent Identifierhttp://hdl.handle.net/10722/300313
ISSN
2020 Impact Factor: 4.467
2015 SCImago Journal Rankings: 1.292
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLaw, CY-
dc.contributor.authorLeung, SC-
dc.contributor.authorLoong, F-
dc.contributor.authorLing, TK-
dc.contributor.authorWong, KC-
dc.contributor.authorLau, NKC-
dc.contributor.authorTsui, SH-
dc.contributor.authorLai, CL-
dc.contributor.authorLam, CW-
dc.date.accessioned2021-06-04T08:41:10Z-
dc.date.available2021-06-04T08:41:10Z-
dc.date.issued2021-
dc.identifier.citationClinical Toxicology, 2021-
dc.identifier.issn1556-3650-
dc.identifier.urihttp://hdl.handle.net/10722/300313-
dc.description.abstractIntroduction: Colloidal silver packaged as a dietary supplement is readily available online and is thought to be safe. Literature describing its toxicity in humans is scarce. Case report: A 47-year-old man presented to us for sensory and gait problems. He had unremarkable past health except dystrophic nails. He further volunteered a history of receiving chronic oral and intravenous administration of colloidal silver. We confirmed his plasma silver was 1200-fold elevated, measuring 11990 nmol/L (normal < 10 nmol/L). He had deranged liver function tests, and liver biopsy showed distorted acinar architecture, bridging fibrosis and lymphocytic infiltrate with silver particles clustering along the vascular endothelium and portal venules. Brain magnetic resonance imagining showed features of mineralization over bilateral globus pallidi. There was biochemical evidence of central adrenal insufficiency, intracellular iron overload and hypoceruloplasminemia (<0.05 g/L). Gradual clinical and biochemical improvement was noted after silver cessation: his plasma silver dropped to 4800 nmol/L (3 months) and 1650 nmol/L (12 months), and serum ceruloplasmin reverted to 0.13 g/L (10 months) and 0.29 g/L (20 months). Conclusions: The potential effects of silver to liver and copper metabolism were shown in this case. Serum ceruloplasmin also serves as a surrogate marker in monitoring silver intoxication.-
dc.languageeng-
dc.publisherTaylor & Francis Inc. The Journal's web site is located at http://www.tandfonline.com/ictx-
dc.relation.ispartofClinical Toxicology-
dc.subjectSilver poisoning / intoxication-
dc.subjectHypoceruloplasminemia-
dc.subjectNeurotoxicity-
dc.subjectWilson disease-
dc.subjectDeranged liver function-
dc.titleSerum ceruloplasmin monitoring in a case of silver intoxication due to intravenous silver infusion-
dc.typeArticle-
dc.identifier.emailLeung, SC: lsc676a@hku.hk-
dc.identifier.emailLing, TK: tkling26@hku.hk-
dc.identifier.emailWong, KC: wkc872@hku.hk-
dc.identifier.emailLai, CL: hrmelcl@hkucc.hku.hk-
dc.identifier.emailLam, CW: ching-wanlam@pathology.hku.hk-
dc.identifier.authorityLeung, SC=rp02523-
dc.identifier.authorityLai, CL=rp00314-
dc.identifier.authorityLam, CW=rp00260-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1080/15563650.2021.1919692-
dc.identifier.pmid34047646-
dc.identifier.scopuseid_2-s2.0-85106696684-
dc.identifier.hkuros322716-
dc.identifier.isiWOS:000655842000001-
dc.publisher.placeUnited States-

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