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) |
|---|---|
| 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 |
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Keywords
- Key Words: Bismuth
- subgallate
- supplements
ASJC Scopus subject areas
- Clinical Neurology
Cite this
Bismuth Subgallate Toxicity in the Age of Online Supplement Use. / Sampognaro, Paul; Vo, Kathy T.; Richie, Megan; Blanc, Paul D.; Keenan, Kevin.
In: Neurologist, Vol. 22, No. 6, 01.01.2017, p. 237-240.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Bismuth Subgallate Toxicity in the Age of Online Supplement Use
AU - Sampognaro, Paul
AU - Vo, Kathy T.
AU - Richie, Megan
AU - Blanc, Paul D.
AU - Keenan, Kevin
PY - 2017/1/1
Y1 - 2017/1/1
N2 - 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.
AB - 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.
KW - Key Words: Bismuth
KW - subgallate
KW - supplements
UR - http://www.scopus.com/inward/record.url?scp=85033236327&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85033236327&partnerID=8YFLogxK
U2 - 10.1097/NRL.0000000000000144
DO - 10.1097/NRL.0000000000000144
M3 - Article
C2 - 29095326
AN - SCOPUS:85033236327
VL - 22
SP - 237
EP - 240
JO - The neurologist
JF - The neurologist
SN - 1074-7931
IS - 6
ER -