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. 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. 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.
Original language | English (US) |
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Pages (from-to) | 237-240 |
Number of pages | 4 |
Journal | Neurologist |
Volume | 22 |
Issue number | 6 |
DOIs | |
State | Published - Jan 1 2017 |
Externally published | Yes |
Keywords
- Key Words: Bismuth
- subgallate
- supplements
ASJC Scopus subject areas
- Clinical Neurology