Template:Heavy metals list - Revision history

Ostermayer at 12:35, 11 March 2026

2026-03-11T12:35:35Z

← Older revision		Revision as of 12:35, 11 March 2026
Line 1:		Line 1:


	~~==See Also==~~
	*[[Aluminum toxicity]]		*[[Aluminum toxicity]]
	*[[Antimony toxicity]]		*[[Antimony toxicity]]
	*[[Arsenic toxicity]]		*[[Arsenic toxicity]]
	*[[Barium toxicity]]		*[[Barium toxicity]]
			*[[Beryllium toxicity]]
	*[[Bismuth toxicity]]		*[[Bismuth toxicity]]
			*[[Boron toxicity]]
	*[[Cadmium toxicity]]		*[[Cadmium toxicity]]
			*[[Cesium toxicity]]
	*[[Chromium toxicity]]		*[[Chromium toxicity]]
	*[[Cobalt toxicity]]		*[[Cobalt toxicity]]
Line 24:		Line 24:
	*[[Thallium toxicity]]		*[[Thallium toxicity]]
	*[[Tin toxicity]]		*[[Tin toxicity]]
			*[[Vanadium toxicity]]
	*[[Zinc toxicity]]		*[[Zinc toxicity]]

Ostermayer at 12:18, 11 March 2026

2026-03-11T12:18:51Z

← Older revision		Revision as of 12:18, 11 March 2026
Line 1:		Line 1:
	~~==Background==~~
	Heavy metal toxicity results from exposure to metals like lead, mercury, arsenic, or cadmium, which interfere with cellular function. Exposure may occur occupationally, environmentally, through ingestion, or from alternative medicines. Chronic toxicity can present insidiously, while acute toxicity may mimic sepsis or encephalopathy. Diagnosis is often delayed due to nonspecific symptoms.

	~~==Clinical Features==~~
	~~Symptoms depend on the metal and exposure duration but may include:~~

	~~Neurologic: Peripheral neuropathy, confusion, tremor, encephalopathy~~

	~~GI: Abdominal pain, nausea, vomiting, diarrhea, anorexia~~

	~~Heme: Anemia (especially microcytic or hemolytic), basophilic stippling (lead)~~

	~~Renal: Tubular dysfunction, proteinuria, Fanconi syndrome~~

	~~Dermatologic: Mees’ lines (arsenic), hyperpigmentation, hair loss~~

	~~Others: Fatigue, weight loss, hypertension (cadmium), immunosuppression~~

	~~==Differential Diagnosis==~~

	~~[[Sepsis (main)\|Sepsis]] or systemic inflammatory response~~

	~~Drug toxicity or overdose~~

	~~Metabolic disorders (e.g., [[Porphyria\|porphyria]], [[Uremia\|uremia]])~~

	~~Psychiatric illness (if symptoms are vague or bizarre)~~

	~~Neurologic diseases (e.g., [[Guillain-Barre syndrome\|Guillain-Barré]], [[Multiple sclerosis\|MS]], [[Parkinson's disease\|Parkinson’s]])~~

	~~[[Vitamin deficiencies]] (e.g., B12, thiamine)~~

	~~==Evaluation==~~

	~~===Workup===~~

	~~History: Occupational exposures, home remedies, hobbies (e.g., jewelry making, battery recycling), diet, water source, imported goods~~

	~~Labs:~~

	* CBC, CMP, urinalysis
	*
	* Blood lead level, serum/urine arsenic, mercury, or cadmium (based on suspicion)
	*
	* Urine heavy metal screen (note: spot testing may require creatinine correction)

	~~Imaging: Abdominal X-ray (radiopaque material in GI tract, especially with lead)~~

	~~EKG: Evaluate for QT prolongation or arrhythmias in severe cases~~

	~~===Diagnosis===~~
	Confirmed by elevated blood or urine levels of the specific metal in the context of clinical findings. Hair and nail testing are unreliable for acute toxicity. Interpret results with toxicologist input if possible.

	~~==Management==~~

	~~Remove the source of exposure (e.g., occupational control, GI decontamination if recent ingestion)~~

	~~Supportive care: IV fluids, seizure control, electrolyte repletion~~

	~~Chelation therapy (in consultation with toxicology or Poison Control):~~

	~~Lead: EDTA, dimercaprol (BAL), succimer~~

	~~Mercury/arsenic: Dimercaprol or DMSA~~

	~~Cadmium: No effective chelation—focus on supportive care~~

	~~Notify local public health authorities if exposure source is environmental or occupational~~

	~~==Disposition==~~

	~~Admit if symptomatic, unstable, or requiring chelation~~

	~~Discharge may be appropriate for asymptomatic patients with low-level exposure and outpatient follow-up~~

	~~Arrange toxicology or environmental medicine follow-up for source control and serial testing~~

	==See Also==		==See Also==

Cole Ettingoff: /* Workup */

2025-06-07T22:31:36Z

Workup

← Older revision		Revision as of 22:31, 7 June 2025
Line 39:		Line 39:
	Labs:		Labs:

	CBC, CMP, urinalysis		* CBC, CMP, urinalysis
			*
	Blood lead level, serum/urine arsenic, mercury, or cadmium (based on suspicion)		* Blood lead level, serum/urine arsenic, mercury, or cadmium (based on suspicion)
			*
	Urine heavy metal screen (note: spot testing may require creatinine correction)		* Urine heavy metal screen (note: spot testing may require creatinine correction)

	Imaging: Abdominal X-ray (radiopaque material in GI tract, especially with lead)		Imaging: Abdominal X-ray (radiopaque material in GI tract, especially with lead)

Cole Ettingoff: /* Differential Diagnosis */

2025-06-07T22:31:10Z

Differential Diagnosis

← Older revision		Revision as of 22:31, 7 June 2025
Line 19:		Line 19:
	==Differential Diagnosis==		==Differential Diagnosis==

	Sepsis or systemic inflammatory response		[[Sepsis (main)\|Sepsis]] or systemic inflammatory response

	Drug toxicity or overdose		Drug toxicity or overdose

	Metabolic disorders (e.g., porphyria, uremia)		Metabolic disorders (e.g., [[Porphyria\|porphyria]], [[Uremia\|uremia]])

	Psychiatric illness (if symptoms are vague or bizarre)		Psychiatric illness (if symptoms are vague or bizarre)

	Neurologic diseases (e.g., Guillain-Barré, MS, Parkinson’s)		Neurologic diseases (e.g., [[Guillain-Barre syndrome\|Guillain-Barré]], [[Multiple sclerosis\|MS]], [[Parkinson's disease\|Parkinson’s]])

	Vitamin deficiencies (e.g., B12, thiamine)		[[Vitamin deficiencies]] (e.g., B12, thiamine)

	==Evaluation==		==Evaluation==

Cole Ettingoff: /* Heavy metal toxicity */

2025-06-07T22:28:41Z

Heavy metal toxicity

@@ Line 1: / Line 1: @@
-===[[Heavy metal]] toxicity===
+==Background==
 *[[Aluminum toxicity]]
 *[[Antimony toxicity]]

ClaireLewis at 20:23, 1 February 2019

2019-02-01T20:23:25Z

← Older revision		Revision as of 20:23, 1 February 2019
Line 16:		Line 16:
	*[[Mercury toxicity]]		*[[Mercury toxicity]]
	*[[Nickel toxicity]]		*[[Nickel toxicity]]
	*[[~~Phosphorous~~ toxicity]]		*[[Phosphorus toxicity]]
	*[[Platinum toxicity]]		*[[Platinum toxicity]]
	*[[Selenium toxicity]]		*[[Selenium toxicity]]

Rossdonaldson1: /* Heavy metal toxicity */

2016-12-10T06:52:38Z

Heavy metal toxicity

@@ Line 1: / Line 1: @@
 ===[[Heavy metal]] toxicity===
-*[[Iron toxicity|Iron]]
+*[[Aluminum toxicity]]
-*[[Lead toxicity|Lead]]
+*[[Antimony toxicity]]
-*[[Arsenic toxicity|Arsenic]]
+*[[Arsenic toxicity]]
-*[[Mercury toxicity|Mercury]]
+*[[Barium toxicity]]
-*[[Zinc]]
+*[[Bismuth toxicity]]

Rossdonaldson1: /* Heavy metal toxicity */

2016-12-04T14:40:40Z

Heavy metal toxicity

← Older revision		Revision as of 14:40, 4 December 2016
Line 1:		Line 1:
	===[[Heavy metal]] toxicity===		===[[Heavy metal]] toxicity===
	*[[Iron toxicity\|Iron]]		*[[Iron toxicity\|Iron]]
	*[[Lead]]		*[[Lead toxicity\|Lead]]
	*[[Arsenic toxicity\|Arsenic]]		*[[Arsenic toxicity\|Arsenic]]
	*[[Mercury toxicity\|Mercury]]		*[[Mercury toxicity\|Mercury]]
	*[[Zinc]]		*[[Zinc]]

Rossdonaldson1: /* Heavy metal toxicity */

2016-12-04T14:37:51Z

Heavy metal toxicity

← Older revision		Revision as of 14:37, 4 December 2016
Line 1:		Line 1:
	===[[Heavy metal]] toxicity===		===[[Heavy metal]] toxicity===
	*[[Iron]]		*[[Iron toxicity\|Iron]]
	*[[Lead]]		*[[Lead]]
	*[[Arsenic toxicity\|Arsenic]]		*[[Arsenic toxicity\|Arsenic]]
	*[[Mercury toxicity\|Mercury]]		*[[Mercury toxicity\|Mercury]]
	*[[Zinc]]		*[[Zinc]]

Rossdonaldson1: /* Heavy metals toxicity */

2016-12-04T14:37:31Z

Heavy metals toxicity

← Older revision		Revision as of 14:37, 4 December 2016
Line 1:		Line 1:
	===[[Heavy ~~metals~~]] toxicity===		===[[Heavy metal]] toxicity===
	*[[Iron]]		*[[Iron]]
	*[[Lead]]		*[[Lead]]