Bismuth Toxicity A Rare Cause of Neurologic Dysfunction英文文献资料.docVIP

International Journal of Clinical Medicine, 2012, 3, 46-48 /10.4236/ijcm.2012.31010 Published Online January 2012 (http://www.SciRP.org/journal/ijcm) Bismuth Toxicity: A Rare Cause of Neurologic Dysfunction Paul T. Reynolds , Kathleen C. Abalos , Jennifer Hopp , Mark E. Williams 1 1 2 1 1 2 University of Virginia, Charlottesville, USA; Hospital of the University of Pennsylvania, Philadelphia, USA. Email: paul.t.reynolds@ Received October 14 , 2011; revised November 30 , 2011; accepted December 25 , 2011 th th th ABSTRACT Bismuth subsalicylate (Pepto-Bismol ) and other bismuth-containing compounds have been used for many years to ? treat gastroenterological complaints. Although safe in the majority of patients, bismuth can cause a well-described toxic state marked by progressive neurological decline. Features of bismuth toxicity include confusion, postural instability, myoclonus, and problems with language [1]. This presentation can masquerade as other causes of progressive neu- rologic dysfunction including Creutzfeld-Jakob Disease (CJD), Hashimoto’s Encephalopathy, and others. In this case study, we present a patient who was using bismuth salicylate in toxic quantities to help control diarrhea. On initial presentation, several diagnoses were entertained before bismuth levels were obtained. This case study highlights the fact that bismuth toxicity, while rare, should be considered in a patient with progressive neurological decline. Also, we hope this case reminds physicians of a severe consequence of a common, readily available medication. Keywords: Bismuth Toxicity; Creutzfeld-Jakob 1. Case Report and strength were normal, but tone was