Cadmium toxicity: Difference between revisions
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*Supplemental oxygen | *Supplemental oxygen | ||
*Monitor [[ABG]], check [[CXR]] | *Monitor [[ABG]], check [[CXR]] | ||
*Treat wheezing and pulmonary edema | *Treat wheezing and [[pulmonary edema]] | ||
===Ingestion=== | ===Ingestion=== | ||
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==See Also== | ==See Also== | ||
*[[Toxicology (main)]] | |||
*[[Heavy Metals]] | *[[Heavy Metals]] | ||
Latest revision as of 01:09, 9 March 2021
Background
- Used in electroplating, soldering, pigments, and plastics
- Once absorbed, cadmium distributes to most major organs, however it has a predilection for the liver and kidneys
Routes of exposure
- Inahlation (up to 25%)
- Cigarette smoking, occupational exposure
- Particle size influences the amount absorbed
- Smaller particles are more likely to penetrate the alveolar-capillary membrane
- Gastrointestinal (1-10%)
- Cadmium is ubiquitous in food systems
- Total daily amount ingested is influenced by a variety of factors
- Reduced total body iron stores leads to upregulation of the gene that encodes for DMT1, a heavy metal transporter located on the luminal side of enterocytes. Consequently, more cadmium is absorbed from the gastrointestinal tract. [1]
- In certain parts of Japan, consumption of cadmium ranges from 59 to 113 mcg per day, which is more than twice the daily average of individuals in Europe. This is in large part due to rice irrigated with cadmium-contaminated water. [2]
- Dermal (less than 1%)
Mechanism of Toxicity
- Inhaled form is 60 times more toxic than ingested form
- Chemical pneumonitis
- Pulmonary edema/hemorrhage
- GI irritation
- Renal tubule damage
Clinical Features
- Local skin and eye irritation
- Cough, wheezing, pulmonary edema
- Nausea, vomiting, diarrhea
- Chronic exposure can lead to bone deposition and "itai-itai" disease
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
- History of exposure and respiratory / gastrointestinal complaints
Management
Inhalation
- Supplemental oxygen
- Monitor ABG, check CXR
- Treat wheezing and pulmonary edema
Ingestion
- Activated charcoal or gastric lavage
- Volume resuscitation to counter fluid losses
- No role for hemodialysis
Disposition
See Also
References
- ↑ Traub, S., & Elinder, C. (2017). Epidemiology and toxicity of cadmium. In G. Curhan (Ed.), UpToDate. UpToDate, Waltham, MA, (Accessed on February 22, 2018).
- ↑ Traub, S., & Elinder, C. (2017). Epidemiology and toxicity of cadmium. In G. Curhan (Ed.), UpToDate. UpToDate, Waltham, MA, (Accessed on February 22, 2018).
- Olson, K. Poisoning and Drug Overdose, 1999.