Antimony poisoning primarily occurs due to inhalational or oral exposure to the metal antimony and can be diagnosed both as acute toxicity or toxicity resulting over a long period of toxin exposure. This condition leads to a multitude of symptoms, affecting the respiratory, gastrointestinal, cardiovascular and reproductive systems, as well as the skin and eyes. Various compounds of antimony, such as antimony oxide, trioxide, pentoxide, trichloride, and trisulfide, have been causally associated with a plethora of abnormalities in humans.

Chronic bronchitis and emphysema, latent tuberculosis, and pneumoconiosis are the main manifestations of antimony poisoning after persistent contact with airborne antimony [1] [2]. Concerning pneumoconiosis, a variety of other potential metallic compounds such as arsenic oxide and sodium hydroxide may have been responsible for the disease, alongside antimony. Refractory cough and inflammation of the respiratory tract are amongst the predominant symptoms while pleural adhesions may also be caused by antimony poisoning. Inhalation of antimony also leads to gastrointestinal (GI) abnormalities, which include abdominal cramping, diarrhea, vomiting and GI ulceration. The trisulfide, oxide and trichloride compounds have been particularly linked to these symptoms, even though co-toxicity due to other metals cannot be excluded [3] [4] [5]. Headache is an additional manifestation associated with antimony poisoning, along with conjunctivitis.

Menstrual irregularities and instances of miscarriage are also symptoms of antimony poisoning [6]. Furthermore, individuals employed in high-temperature working spaces tend to develop dermal pustules referred to as antimony spots, in regions adjacent to sebaceous and sweat glands [7] [8]. Chronic antimony poisoning by inhalation has been considered the culprit behind cardiovascular pathologies, such as an elevated blood pressure and T-wave abnormalities, although a firm association has yet to be established [9]. A 1990 study also suggested that antimony poisoning of infants from antimony-containing cot mattress covers was the cause of Sudden Infant Death Syndrome (SIDS) [10].

Ingested antimony compounds are also known to lead to poisoning; individuals are expected to develop symptoms such as vomiting, nausea, epigastralgia and abdominal cramps, which can persist for days after the initiation of treatment [11].

Antimony poisoning can also be caused by antimonials used to treat other diseases, such as leishmaniasis and schistosomiasis. Pentavalent antimonials used to cure leishmaniasis can induce poisoning which may rarely manifest with cardiotoxicity and death [12] [13] [14] [15] [16]. Pancreatitis, leukopenia and acute renal failure can also be ways in which antimony poisoning from therapeutic agents can present, especially in HIV-positive patients suffering from visceral leishmaniasis. Trivalent antimonials used to treat schistosomiasis were also a confirmed cause of antimony poisoning and patients presented with anorexia, vomiting, electrocardiographic abnormalities, while acute vascular collapse has also been documented; these drugs were discontinued as a therapy against schistosomiasis in 1970 [17] [18].

• Anemia

  Monjack's autopsy listed “acute pneumonia and severe anemia” as his cause of death. [medpagetoday.com]

  Arsenic Useful lab tests include Urinalysis ( Oliguria, Hematuria, Hemoglobinuria); Complete Blood Count and Peripheral Smear (Macrocytic Anemia ); Tissue Exam (reveals arsenic deposits – urine, nails, hair) and Serum Arsenic levels. [diagnose-me.com]

  Weakness, anemia, loss of weight and general depression may also occur. [espimetals.com]

• Gastric Lavage

  Gastric lavage, i.e., washing the stomach with sterile or saltwater to remove poison, may also be administered. [buzzle.com]

  Treatment is the same as for arsenic and other heavy metal poisoning—gastric lavage if it has been ingested recently, then treatment with chelating agents that will bind with the metal so the body will eliminate it naturally. [annerallensbooks.blogspot.com]

  MANAGEMENT Ingestion Decontamination Following ingestion of an antimony compound gastric lavage may be considered if presentation is within the first hour. [inchem.org]

• Vomiting

  Inhalation of antimony also leads to gastrointestinal (GI) abnormalities, which include abdominal cramping, diarrhea, vomiting and GI ulceration. [symptoma.com]

  It is characterized by vomiting, diaphoresis, diarrhea, and a metallic taste in the mouth. Irritation of the skin or mucous membranes may result from external exposure. Severe poisoning resembles arsenic poisoning. [medical-dictionary.thefreedictionary.com]

  July 23, 2012, 11:42 pm A 34-Year-Old Man with Intractable Vomiting after Ingestion of an Unknown Substance. Konstantopoulos WM et al. N Engl J Med 2012 Jul 19;376:259-68. [thepoisonreview.com]

  Wikimedia Commons Vomiting, diarrhoea and liver damage may have been a part of daily life for Romans in Pompeii. [ibtimes.co.uk]

  Along with diarrhea and vomiting, it can cause cardiac arrest in severe cases. This toxic chemical element also naturally occurs in groundwater near volcanoes. [iflscience.com]

• Diarrhea

  It is characterized by vomiting, diaphoresis, diarrhea, and a metallic taste in the mouth. Irritation of the skin or mucous membranes may result from external exposure. Severe poisoning resembles arsenic poisoning. [medical-dictionary.thefreedictionary.com]

  Along with diarrhea and vomiting, it can cause cardiac arrest in severe cases. This toxic chemical element also naturally occurs in groundwater near volcanoes. [iflscience.com]

  The element is particularly irritating to the bowels, and the reactions are excessive vomiting and diarrhea that can lead to dehydration. [sciencedaily.com]

  Inhalation of antimony also leads to gastrointestinal (GI) abnormalities, which include abdominal cramping, diarrhea, vomiting and GI ulceration. [symptoma.com]

  For the people drinking the water that ran through these pipes, this could have brought on severe health consequences, including vomiting, diarrhea, liver and kidney damage, and in extreme cases, even cardiac arrest. [dailymail.co.uk]

• Nausea

  Ingested antimony compounds are also known to lead to poisoning; individuals are expected to develop symptoms such as vomiting, nausea, epigastralgia and abdominal cramps, which can persist for days after the initiation of treatment. [symptoma.com]

  Arsenic Symptoms include nausea or vomiting, abdominal pain, diarrhea, garlic odor on breath, excessive salivation, headache, vertigo, fatigue, paresthesia, paralysis, kidney failure, progressive blindness, and mental impairment. [diagnose-me.com]

  Low doses cause headaches, nausea, dizziness and depression. Large doses cause vomiting, diarrhea, abdominal discomfort and tingling of the extremities. Despite the fact that large doses work as an emetic, if left untreated, a person may die. [buzzle.com]

  In battery plant workers, median blood antimony concentrations of 2.6 mcg/L were found in metal casters and 10 mcg/L in metal formers.(4) The effects of acute or chronic antimony poisoning are similar to arsenic and include abdominal pain, dyspnea, nausea [mayomedicallaboratories.com]

  Looking for adverse effects, patients were asked about abdominal pain, nausea, vomiting or anorexia in each medical visit. [allaboutheaven.org]

• Abdominal Pain

  In the latest Case Record of the Massachusetts General Hospital, a 34-year-old man was seen in the emergency department because of abdominal pain and vomiting after his wife had given him a powder to cause him to stop drinking alcohol. [blogs.nejm.org]

  Repeated prolonged exposure to airborne antimony trichloride, antimony trisulfide or antimony oxide was seen to cause abdominal pain, diarrhea, vomiting, and ulcers. [holicolorsindia.com]

  Arsenic Symptoms include nausea or vomiting, abdominal pain, diarrhea, garlic odor on breath, excessive salivation, headache, vertigo, fatigue, paresthesia, paralysis, kidney failure, progressive blindness, and mental impairment. [diagnose-me.com]

  pain, dyspnea, nausea, vomiting, dermatitis, and visual disturbances.(1) Additionally, toxicity can include pneumoconiosis, and altered electrocardiograms.(2) Normal blood concentrations are 0.7-2 ng/mL in the unexposed, and 2.6-10 ng/mL in exposed workers [mayomedicallaboratories.com]

  Mrs Spink died in December 1897 after an illness with symptoms that included abdominal pains and vomiting. In 1898 one of his barmaids, Bessie Taylor, became his mistress. [murderpedia.org]

• Abdominal Cramps

  Inhalation of antimony also leads to gastrointestinal (GI) abnormalities, which include abdominal cramping, diarrhea, vomiting and GI ulceration. [symptoma.com]

  At the time of her death, Murphy had displayed several symptoms consistent with heavy metal poisoning: headaches, dizziness, abdominal cramps, coughing, sweating, disorientation, wheezing, congestion and pneumonia. [medpagetoday.com]

• Heart Disease

  Symptoms of antimony toxicity Symptoms associated with antimony vary depending on the amount you are currently exposed to, here are some of the more common symptoms: Raised blood cholesterol (LDL) Gallstones Heart disease Cardiovascular disease Increased [naturalhealthgroup.com.au]

• Jaundice

  […] liver failure not induced by acetaminophen, poor prognostic factors include a prothrombin time of more than 100 seconds or any three of the following criteria: drug toxicity or indeterminate cause, an age younger than 10 years or older than 40 years, a jaundice-to-coma [blogs.nejm.org]

• Dermatitis

  […] workers, median blood antimony concentrations of 2.6 mcg/L were found in metal casters and 10 mcg/L in metal formers.(4) The effects of acute or chronic antimony poisoning are similar to arsenic and include abdominal pain, dyspnea, nausea, vomiting, dermatitis [mayomedicallaboratories.com]

  Injection Dermal toxicity Davis (1968) reported antimony dermatitis in some four per cent of 160 patients treated with antimonial drugs. [inchem.org]

  Vitamin B3 deficiency – Lack of energy, diarrhea, insomnia, headaches or migraines, poor memory, anxiety or tension, depression, irritability, bleeding or tender gums, acne, eczema/dermatitis can all be indications of antimony toxicity. [naturalhealthgroup.com.au]

• Flushing

  They then get flushed out with your pee. Chelation can be an important part of treatment. But the therapy can be dangerous, and it doesn’t work with all heavy metals. [webmd.com]

  EYES : Flush eyes with lukewarm water, including under upper and lower eyelids, for at least 15 minutes. Seek medical attention if irritation develops or persists. Most Important Symptoms/Effects, Acute and Delayed : May cause irritation. [espimetals.com]

• Eczema

  Vitamin B3 deficiency – Lack of energy, diarrhea, insomnia, headaches or migraines, poor memory, anxiety or tension, depression, irritability, bleeding or tender gums, acne, eczema/dermatitis can all be indications of antimony toxicity. [naturalhealthgroup.com.au]

  Papules and pustules predominate around sweat and sebaceous glands with areas of eczema and lichenification. These so-called "antimony spots" occur mainly in the summer (McCallum, 1989). [inchem.org]

• Headache

  Damaged lungs, degraded muscles: Why flu makes you feel so bad 1/2/19 We all know the symptoms of influenza infection include fever, cough, sore throat, muscle aches, headaches and fatigue. But just what causes Read More [barnstablecountyhealth.org]

  Symptoms of heavy metal toxicity include mental confusion, pain in muscles and joints, headaches, short-term memory loss, gastrointestinal upsets, food intolerances/allergies, vision problems, chronic fatigue, and others. [diagnose-me.com]

  Headache is an additional manifestation associated with antimony poisoning, along with conjunctivitis. Menstrual irregularities and instances of miscarriage are also symptoms of antimony poisoning. [symptoma.com]

  Low doses cause headaches, nausea, dizziness and depression. Large doses cause vomiting, diarrhea, abdominal discomfort and tingling of the extremities. Despite the fact that large doses work as an emetic, if left untreated, a person may die. [buzzle.com]

  In small doses, antimony causes headache, dizziness and depression. Larger doses cause violent and frequent vomiting, and will lead to death in few days. [pt.chemicalstore.com]

• Confusion

  Mental symptoms include restlessness, insomnia, irritability, confusion, excitement, anxiety, delusions, and disturbing dreams. [diagnose-me.com]

  Symptoms usually come on quickly and you may: Feel confused Go numb Feel sick and throw up Pass out Acute poisoning is an emergency. Call your doctor or local poison control center right away. The national Poison Help Line is 800-222-1222. [webmd.com]

  Signs of acute poisoning include confusion, numbness, nausea and vomiting, and coma. Other frequent finding include metabolic acidosis, acute tubular necrosis, encephalopathy, cardiomyopathy and dysrhythmias. [medpagetoday.com]

  The pure metalloid was usually confused with Lead. The Sulfide was called Stibi or stimmi in Ancient Greek, stibium in Latin ("stibium" was used by Pliny in 50 AD. [3rd1000.com]

The complete workup in order to diagnose antimony poisoning requires a thorough medical history, including potential exposure to metals. Occupational exposure is most common, as workers in metallurgy plants, mines, and other similar workplaces are susceptible to antimony poisoning.

A complete blood count and biochemical profile are performed to assess patient status and evaluate creatinine, electrolytes and hematocrit levels. Sector field and quadrupole inductively coupled plasma mass spectrometry can be used to detect antimony in the urine. Levels that exceed 10 mcg/L are deemed elevated [19]. The toxic metal can also be found and measured in the blood, hair, and feces; blood levels greater than 2 ng/mL are also considered compatible with antimony poisoning [20]. The workup is completed with a multitude of other procedures aimed at assessing each case separately, depending on the symptoms with which an individual presents.

Treatment is the same as for arsenic and other heavy metal poisoning—gastric lavage if it has been ingested recently, then treatment with chelating agents that will bind with the metal so the body will eliminate it naturally. [annerallensbooks.blogspot.com]

Antimony poisoning involves a toxic effect caused by a prolonged exposure to higher-than-normal concentrations of antimony, found either in the workplace or in therapeutic agents administered for the treatment of other conditions. [symptoma.com]

Many businesses sell unreliable tests and expensive or even dangerous treatments. Hair analysis or chelation challenge tests (“provoked urine ” tests). They’re inaccurate. They can’t tell you if you’re sick or need treatment. [webmd.com]

M.D. visit: Lead is an environmental toxin and measurements of high levels in the bloodstream require treatment. Avoiding the source of lead, having your home and water supply inspected for possibly sources may be completed by the health department. [healthtap.com]

Toxicity can also result from repeated exposure to antimony in medications, such as tartar emetic (antimony and potassium tartrate), used to induce vomiting and in treatment of helminthic and fungal infestations. [britannica.com]

Q: What are the indicators of poor prognosis in acute liver failure? A: The King’s College Hospital criteria remain the most used prognostic criteria for acute liver failure. [blogs.nejm.org]

Prognosis; Complications Although complete cure is possible, many people suffer the effects of toxicity for extended periods. Some of the damage, for instance to the liver or brain, may not be fully reversible. [diagnose-me.com]

Página 330 - Intestinal infections in patients with the acquired immunodeficiency syndrome (AIDS): etiology and response to therapy. ‎ [books.google.es]

Etiology, clinical and x-ray findings. Int Arch Occup Environ Health 1983; 51: 199-207. Rai US, Kumar H, Kumar U. Renal dysfunction in patients of kala azar treated with sodium antimony gluconate. [inchem.org]

We discuss their sources, toxic effects, and epidemiology, as well as identify groups at risk for toxic exposure. [allaboutheaven.org]

An epidemiological survey carried out by Professor Peter Fleming of the Institute of Child Health at the Royal Hospital for Sick Children in Bristol came to the conclusion that PVC-covered mattresses were less likely to be associated with cot death. [flandershealth.us]

Página 302 - Groszmann RJ, Atterbury CE: The pathophysiology of portal hypertension: a basis for classification. Semin Liver Dis 1982; 2:177. ‎ [books.google.es]

AND MANAGEMENT Health Risks of Underground Construction Work Bohuslav Mdlek 93 8 MAJOR SECTORS AND THEIR HAZARDS TOOLS EQUIPMENT AND MATERIALS Elevators Escalators and Hoists J Staal and John Quackenbush 93 40 Prevention of Occupational Dermatosis among [books.google.com]

Página 302 - Lee GC-Y, et al: Prevention of perinatally transmitted hepatitis B virus infection with hepatitis B immune globulin and/or HB vaccine, in Vyas GN, Dienstag JL, Hoofnagle JH (eds): Viral Hepatitis and Liver Disease. ‎ [books.google.es]

The goal of chelation is to form a stable complex between antimony and the sulfur donors, or dithiols, on the chelator, preventing the antimony from chelating host enzymes. [blogs.nejm.org]

Centers for Disease Control and Prevention is opening an investigation into the safety of firefighters’ uniforms containing antimony trioxide, a chemical compound used as a flame retardant. [findingdulcinea.com]

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