Aluminum toxicity
Aluminum Metal
- Dusts cause respiratory tract and eye irritation
- Acute exposures can cause bronchoconstriction and asthma-like response
- Chronic exposure can lead to pulmonary fibrosis
- Increased incidence of cancer
Aluminum phosphide
- Used as a fumigant
- Contact with moisture produces phosphine gas
- Respiratory tract irritant
Aluminum oxide
- Physical irritant, nuisance particulate
Systemic aluminum toxicity
- Usually in renal patients on long-term dialysis with aluminum-containing dialysate
- Rarely acute
- Muscle weakness (especially proximal)
- Premature osteoporosis, bone pain, multiple fractures
- Seziures
- Acute or subacute altered mental status
Differential Diagnosis
Heavy metal toxicity
- Aluminum toxicity
- Antimony toxicity
- Arsenic toxicity
- Barium toxicity
- Bismuth toxicity
- Cadmium toxicity
- Chromium toxicity
- Cobalt toxicity
- Copper toxicity
- Gold toxicity
- Iron toxicity
- Lead toxicity
- Lithium toxicity
- Manganese toxicity
- Mercury toxicity
- Nickel toxicity
- Phosphorus toxicity
- Platinum toxicity
- Selenium toxicity
- Silver toxicity
- Thallium toxicity
- Tin toxicity
- Zinc toxicity
Evaluation
- Aluminum level > 50 µg/L (mcg/dL) suggests aluminum overload and possible toxicity
- Symptomatic patients with levels 20-50 may also need treatment
Management
- Stop exposure
- Chelation with deferoxamine for severe or symptomatic systemic toxicity