A fatal case of potassium dichromate ingestion is documented. A retrospective review of serum and organ levels of chromium demonstrates that charcoal haemoperfusion, peritoneal and haemodialysis are ineffective therapies for the toxin. Other treatments for this poisoning are reviewed, the poor prognosis of dichromate ingestion, and the paucity of effective therapy underlined. The application of dichromates in traditional medications is briefly discussed; this is a toxin which may be more prevalent than previously thought. It is proposed that the exposure limits of dichromate be more widely publicised.
Get full access to this article
View all access options for this article.
References
1.
Witchdoctor's Association of Southern Africa and the Natal Herbalists' Supply Company , personal communication.
2.
Morice A.Adulteration of homeopathic remedies . Lancet1987; 1: 635.
3.
Health and Safety Executive Report EH 40/89.List of Occupational Exposure Limits. London, 1989.
4.
Baser Khc , Honda G. & Miki W.Herb Drugs and Herbalists in Turkey. Tokyo: Studia Culture Islamicae 27, 1986.
5.
Burnett J.Plenty and Want - a social history of diet in England form 1815 to the present day. London: Methuen, 1985.
6.
Dr M Pascoe, Renal Unit, Groote Schuur Hospital, Cape Town, personal communication.
7.
Anderson RA , Bruden MA & Polansky MMSerum chromium of human subjects: effects of supplementation of chromium and glucose. American Journal of Clinical Nutrition1985; 41: 571-7.
8.
Levis AG & Bianchi V.Mutagenic and cytogenic effects of chromium compounds. In: Biological and Environmental Aspects of Chromium, ed Langhard S.Amsterdam: 1982.
9.
Debetto P. & Luciani S.Toxic effect of chromium on cellular metabolism. Science of the Total Environment1988; 71: 365-77.
10.
Ueno S. , Susa N., Furukawa Y., Aikawa K. & Itagaki I.Cellular injury and lipid peroxidation induced by hexavalent chromium in isolated rat hepatocytes. Nippon Juigaku Zasshi1989 ; 51: 137-45.
11.
Martindale. The Extra Pharmacopoeia, ed Reynolds JEF, 29th edn. London : The Pharmaceutical Press, 1989 .
12.
Gosselin RE , Smith RO & Hodge HCClinical Toxicology of Commercial Products. Baltimore: Williams and Wilkins, 1975.
13.
Walpole IR , Johnston K., Clarkson R., Wilson G. & Bower G.Acute chromium poisoning in a 2 year old child. Australian Paediatric Journal1985; 21: 65-7.
14.
Appenroth D. & Braunlich H.Age dependent differences in sodium dichromate toxicity in rats. Experimental Pathology1988 ; 33: 179-85.
Sharma BK , Singhal PC & Chulgh KSIntravascular haemolysis and acute renal failure following potassium dichromate poisoning. Postgraduate Medical Journal1978 ; 54: 414-15.
17.
Baselt RCDisposition of Toxic Drugs and Chemicals in Man, 2nd edn. Davis: Biomedical Publications , 1974.
18.
Cavalleri A. , Minoia C., Richelmi P., Baldi C. & Micoli G.Determination of total and hexavalent chromium in bile after intravenous administration of potassium dichromate in rats. Environmental Research1985; 37: 490-6.
19.
Ellis ENFatal poisoning with sodium dichromate . Journal of Toxicology and Clinical Toxicology1982; 19: 249.
20.
Fristedt B. , Lindquist B., Schutz A. & Ovrum P.Survival in a case of acute oral chromic acid poisoning with acute renal failure treated by haemodialysis. Acta Med Scandinavia1965; 2: 153-9.
