Barium poisoning

Proposed mechanism of toxicity is blockage of cellular efflux of potassium, but not uptake, causing hypokalemia, which maybe severe 

Abdomen, epigastrium - pain Bowel movements - diarrhea Heart, rhythm - irregular [2] 

Blood creatine phosphokinase (CPK) - increased Blood creatinine - increased Blood phosphate - decreased Blood potassium - decreased Blood urea nitrogen - increased 

AV conduction - AV dissociation, complete Dysrhythmias, ventricular QRS - long 

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The barium ion is a physical antagonist of potassium, and it appears that the symptoms of barium poisoning are attributable to Ba -induced hypokalemia. The effect is probably due to a transfer of potassium from extracellular to intracellular compartments rather than to urinary or gastrointestinal losses. Signs and symptoms are relieved by intravenous infusion ofKh ... 

There is no routine medical test to determine whether you have been exposed to barium. Doctors can measure barium in body tissues and fluids, such as blood, bones, urine, and feces, using very complex instruments. This is normally done only for cases of severe barium poisoning and for medical research. More information on testing for barium exposure is found in Chapters 2 and 6. 

Hematological Effects. In human case studies of oral barium poisoning, a decrease in serum potassium is frequently observed in the subjects (Diengott et al. 1964 Gould et al. 1973 Lewi and Bar-Khayim 1964 Phelan et al. 1984 Talwar and Sharma 1979 Wetherill et al. 1981). 

Renal failure was reported in one case study of a human exposed by acute inhalation to barium (Shankle and Keane 1988). Case studies of humans developing renal failure, renal insufficiency, and renal degeneration following acute oral barium poisoning have been reported (Gould et al. 1973 ... 

One in vitro study on rat renal tissue homogenate showed barium weakly inhibited the sodium-potassium-adenosine triphosphatase enzyme system (Kramer et al. 1986). A second study on mouse kidney tubules showed barium chloride could depolarize the membrane and inhibit potassium transport (Volkl et al. 1987). A similar defect in cell membrane transport in humans could be responsible for the renal involvement observed in some cases of acute barium poisoning. 

Roza and Berman 1971 Schott and McArdle 1974) and is used as an antidote in cases of acute barium poisoning. Calcium and magnesium suppress uptake of barium in vitro in pancreatic islets. Conversely, barium, in low concentrations, stimulate calcium uptake in these cells. Although the data are insufficient to determine the significance of these findings to human health effects, displacement of calcium may be the mechanism by which barium stimulates insulin release (Berggren et al. 1983). 

Children may be at an increased risk since animal studies have demonstrated a higher absorption rate among younger animals than older animals (Taylor et al. 1962). However, a study of an epidemic of oral barium poisoning in Poland indicated that children did not react as adversely as adults even when they had ingested the same amount or more of barium (Lewi and Bar-Khayim 1964 Ogen et al. 1967). 

Hypokalemia is commonly seen in cases of acute barium toxicity and may be responsible for some of the symptoms of barium poisoning (Proctor et al. 1988). Plasma potassium should be monitored and hypokalemia may be relieved by intravenous infusion of potassium (Dreisbach and Robertson 1987 Haddad and Winchester 1990 Proctor et al. 1988). 

Diengott D, Rozsa O, Levy N, et al. 1964. Hypokalemia in barium poisoning. Lancet 2 343-344. 

Jaklinski A, Maj J, Przegalinski E. 1967. Experimental studies on barium poisoning. J Forensic Med 14 13-15. 

C.H. Johnson, and V.J. VanTassell, Acute barium poisoning with respiratory failure and rhabdomyolysis. Ann. Emer. Med. 20 1138, 1991. 

Govindiah D, Bhaskar GR. An unusual case of barium poisoning. Antiseptic 1972 69 675. 

Ammonia poisoning Arsine poisoning Barium poisoning Benzene poisoning Bromine poisoning Carbon monoxide poisoning Chlorine poisoning Cholera... 

Anthrax, 3-9 Avian influenza, 10-14 Barium poisoning, 293-296 Brucellosis, 25-29... 

Barium poisoning may cause hypokalemia, high blood pressure, renal failure, and death by cardiac arrest (Patton 1994, Downs 1995, Fogliani et al. 1993, Johnson and Vantassell 1991, Agarwal et al. 1995, Gupta 1994, Sandmeyer and Probst 1988). 

Johnson CH and Vantassell VJ (1991) Acute barium poisoning with respiratoryfailure and rhabdomyolysis. Ann Emerg Med 20 1138-1142. 

Barium poisonings are uncommon and usually result from accidental contamination of food sources, suicidal ingestion, or occupational inhalation exposure. The water-soluble barium salts (acetate, carbonate, chloride, fluoride, hydroxide, nitrate, and sulfide) are highly toxic, whereas the insoluble salt, barium sulfate, is nontoxic because it is not absorbed. Soluble barium salts are found in depilatories, fireworks, ceramic glazes, and rodenticides and are used in the manufacture of glass and in dyeing textiles. Barium sulfide and polysulfide may also produce hydrogen sulfide toxicity (see p 224). 

A. Systemic barium poisoning is characterized by profound hypokalemia,... 

Hemodialysis and hemoperfusion have not been evaluated In the treatment of serious barium poisoning. Hemodialysis might be helpful In correcting severe electrolyte disturbances. 

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