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Bismuth Subgallate Toxicity in the Age of Online Supplement Use.

Authors :
Sampognaro P
Vo KT
Richie M
Blanc PD
Keenan K
Source :
The neurologist [Neurologist] 2017 Nov; Vol. 22 (6), pp. 237-240.
Publication Year :
2017

Abstract

Introduction: Bismuth salts have been used to treat gastroenterological disorders and are readily available over-the-counter and via the internet. Even though generally considered safe, bismuth compounds can cause a syndrome of subacute, progressive encephalopathy when taken in large quantities.<br />Case Report: We present the case of woman who developed progressive encephalopathy, aphasia, myoclonus, and gait instability after chronically ingesting large amounts of bismuth subgallate purchased from a major online marketing website to control symptoms of irritable bowel syndrome. After extensive neurological work-up, elevated bismuth levels in her blood, urine, and cerebrospinal fluid confirmed the diagnosis of bismuth-related neurotoxicity. She improved slowly following cessation of exposure.<br />Conclusion: This case highlights bismuth subgallate as a neurotoxic bismuth formulation and reminds providers of the potential for safety misconceptions of positively reviewed online supplements.

Details

Language :
English
ISSN :
2331-2637
Volume :
22
Issue :
6
Database :
MEDLINE
Journal :
The neurologist
Publication Type :
Academic Journal
Accession number :
29095326
Full Text :
https://doi.org/10.1097/NRL.0000000000000144