Chromium toxicity - Revision history

Elcatracho: /* Management */

2021-03-09T01:14:33Z

Management

← Older revision		Revision as of 01:14, 9 March 2021
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	**[[Activated charcoal]] not indicated		**[[Activated charcoal]] not indicated
	**Consider [[NG lavage]] if Cr<sup>6+</sup> ingestion and presenting within 1-2 hours without signs of vomiting		**Consider [[NG lavage]] if Cr<sup>6+</sup> ingestion and presenting within 1-2 hours without signs of vomiting
	**Consider oral N-acetylcysteine		**Consider oral [[N-acetylcysteine]]
	***Shown to increases renal elimination of chromium in rats		***Shown to increases renal elimination of chromium in rats
	*Supportive care		*Supportive care
	*Chelation		*Chelation
	**Not effective in reducing chromium levels		**Not effective in reducing chromium levels
	*Dialysis		*[[Dialysis]]
	**Not effective in those with normal renal function		**Not effective in those with normal renal function
	**Consider in those on chronic dialysis		**Consider in those on chronic dialysis

Elcatracho: /* See Also */

2021-03-09T01:11:31Z

Elcatracho: /* Management */

2021-03-09T01:10:29Z

Management

← Older revision		Revision as of 01:10, 9 March 2021
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	==Management==		==Management==
	*Decontamination		*Decontamination
	**Activated charcoal not indicated		**[[Activated charcoal]] not indicated
	**Consider NG lavage if Cr<sup>6+</sup> ingestion and presenting within 1-2 hours without signs of vomiting		**Consider [[NG lavage]] if Cr<sup>6+</sup> ingestion and presenting within 1-2 hours without signs of vomiting
	**Consider oral N-acetylcysteine		**Consider oral N-acetylcysteine
	***Shown to increases renal elimination of chromium in rats		***Shown to increases renal elimination of chromium in rats
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	**Not effective in those with normal renal function		**Not effective in those with normal renal function
	**Consider in those on chronic dialysis		**Consider in those on chronic dialysis

	==Disposition==		==Disposition==
	*Acute toxicity likely requires intensive care unit		*Acute toxicity likely requires intensive care unit

Rossdonaldson1: /* References */

2021-01-12T17:16:40Z

References

← Older revision		Revision as of 17:16, 12 January 2021
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	*Acute toxicity likely requires intensive care unit		*Acute toxicity likely requires intensive care unit
	*Consult Toxicology or [[poison control]]		*Consult Toxicology or [[poison control]]
			==See Also==

			==External Links==

	==References==		==References==
	<references/>		<references/>
	Bird, S. Chromium. In: Goldfrank's Toxicologic Emergencies. 9th Ed. New York: McGraw-Hill; 2011: 1243-1247		*Bird, S. Chromium. In: Goldfrank's Toxicologic Emergencies. 9th Ed. New York: McGraw-Hill; 2011: 1243-1247

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

SeanDenny: /* Acute */

2020-12-14T22:34:25Z

Acute

← Older revision		Revision as of 22:34, 14 December 2020
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	===Acute===		===Acute===
	*Similar to corrosive metal ingestions		*Similar to corrosive metal ingestions
	*[[~~GI hemorrhage~~]]		*[[Gastrointestinal bleeding]]
	*[[Vomiting]]		*[[Vomiting]]
	*[[Bowel perforation]]		*[[Bowel perforation]]

Rossdonaldson1: Text replacement - "BSA" to "BSA"

2019-02-12T07:04:03Z

Text replacement - "BSA" to "BSA"

← Older revision		Revision as of 07:04, 12 February 2019
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	*[[Acute lung injury]]		*[[Acute lung injury]]
	*Skin inflammation and ulcerations		*Skin inflammation and ulcerations
	**Dermal chromic acid (H<sub>2</sub>CrO<sub>4</sub>) can lead to systemic toxicity with as little as 10% BSA		**Dermal chromic acid (H<sub>2</sub>CrO<sub>4</sub>) can lead to systemic toxicity with as little as 10% [[BSA]]

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

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

2018-08-14T11:51:08Z

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

← Older revision		Revision as of 11:51, 14 August 2018
Line 102:		Line 102:
	==Disposition==		==Disposition==
	*Acute toxicity likely requires intensive care unit		*Acute toxicity likely requires intensive care unit
	*Consult Toxicology or ~~Poison Control Center~~		*Consult Toxicology or [[poison control]]
	==References==		==References==
	<references/>		<references/>

Rossdonaldson1: /* Differential Diagnosis */

2018-08-12T21:23:26Z

Differential Diagnosis

@@ Line 71: / Line 71: @@
 ==Differential Diagnosis==
-===[[Heavy metal]] toxicity===
+{{Heavy metals list}}
-*[[Aluminum toxicity]]
 ==Evaluation==
 *BMP

Rossdonaldson1: /* Clinical Features */

2018-08-12T21:23:07Z

Clinical Features

← Older revision		Revision as of 21:23, 12 August 2018
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	==Clinical Features==		==Clinical Features==
	*'''Acute~~'''~~		===Acute===
	**Similar to corrosive metal ingestions		*Similar to corrosive metal ingestions
	**GI hemorrhage		*[[GI hemorrhage]]
	**Vomiting		*[[Vomiting]]
	**Bowel perforation		*[[Bowel perforation]]
	**Intravascular hemolysis with [[DIC]]		*Intravascular hemolysis with [[DIC]]
	**[[Acute tubular necrosis]] and [[Renal failure]]		*[[Acute tubular necrosis]] and [[Renal failure]]
	**[[Metabolic acidosis]]		*[[Metabolic acidosis]]
	**[[Hyperkalemia]]		*[[Hyperkalemia]]
	**[[Acute lung injury]]		*[[Acute lung injury]]
	**Skin inflammation and ulcerations		*Skin inflammation and ulcerations
	***Dermal chromic acid (H<sub>2</sub>CrO<sub>4</sub>) can lead to systemic toxicity with as little as 10% BSA		**Dermal chromic acid (H<sub>2</sub>CrO<sub>4</sub>) can lead to systemic toxicity with as little as 10% BSA
	*'''Chronic~~'''~~
	**Most are occupational inhalation exposures		===Chronic===
	**Chrome holes		*Most are occupational inhalation exposures
	***Nasal septal perforation		*Chrome holes
	***Skin ulcerations		**Nasal septal perforation
	**Chronic cough		**Skin ulcerations
	**Dyspnea and bronchospasm		*Chronic cough
	**Anaphylactoid-like reactions		*Dyspnea and bronchospasm
	**Pneumoconicosis		*Anaphylactoid-like reactions
	**Increase risk of lung cancer		*Pneumoconicosis
	***Small cell lung cancer, however all types are associated with Cr<sup>6+</sup> exposure		*Increase risk of lung cancer
	**[[Contact dermatitis]] and [[Type IV hypersensitivity reaction]]		**Small cell lung cancer, however all types are associated with Cr<sup>6+</sup> exposure
			*[[Contact dermatitis]] and [[Type IV hypersensitivity reaction]]

	==Differential Diagnosis==		==Differential Diagnosis==
	===[[Heavy metal]] toxicity===		===[[Heavy metal]] toxicity===

Rossdonaldson1: /* Chromium levels */

2018-08-10T03:06:34Z

Chromium levels

← Older revision		Revision as of 03:06, 10 August 2018
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	===Chromium levels===		===Chromium levels===
			''Baseline levels have varied over the past 50 years by 5000-fold, additionally it is difficult to establish standard reference range, use caution when interpreting these levels; phlebotomy needles and blood containers for storage can contain chromium''
	*Whole blood: 20-30 μg/L (380-580 nmol/L)		*Whole blood: 20-30 μg/L (380-580 nmol/L)
	*Serum: 0.05-2.86 μg/L (1-56 nmol/L)		*Serum: 0.05-2.86 μg/L (1-56 nmol/L)
	*Urine: < 1μg/g creatinine (<19.2 nmol/g creatinine)		*Urine: < 1μg/g creatinine (<19.2 nmol/g creatinine)
	**Can reflect acute absorption of chromium over the past 1-2 days, however wide variation in metabolism and total body burden		**Can reflect acute absorption of chromium over the past 1-2 days, however wide variation in metabolism and total body burden
	*Baseline levels have varied over the past 50 years by 5000-fold, additionally it is difficult to establish standard reference range, use caution when interpreting these levels
	*Phlebotomy needles and blood containers for storage contain chromium

	==Management==		==Management==

← Older revision		Revision as of 01:11, 9 March 2021
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	*Consult Toxicology or [[poison control]]		*Consult Toxicology or [[poison control]]
	==See Also==		==See Also==
			*[[Toxicology (main)]]
			*[[Heavy Metals]]

	==External Links==		==External Links==