Bronze skin

Levinsky et al. (1970) reported on three men exposed to an unknown concentration of arsine for an estimated, 2, 3, and 15 min. Signs and symptoms of exposure (malaise, headache, abdominal pain, chills, nausea, vomiting, oliguria/ anuria, hematuria, bronze skin color) developed within 1-2 h. All three individuals required extensive medical intervention to save their lives. Clinical findings were indicative of massive hemolysis and repeated blood exchange transfusions were necessary for the survival of these individuals. 

An unusual bronze skin color has been noted in some patients pigmentation of the skin and mucous membranes is more often described as ordinary jaundice and is seen in most poisoning cases. Oliguria or anuria, the most serious manifestation, may become manifest before the third day. In fatal cases, death... 

At lower concentrations toxic effects may manifest few hours after exposure. The symptoms include headache, weakness, dizziness, dyspnea, abdominal pain, nausea, vomiting and bronze skin. Chronic exposure can produce jaundice, hemolytic anemia and hemoglobinuria. PEL-TWA and TLV-TWA 0.05 ppm or 0.2 mg/m3 (OSHA and ACGIH). 

The family history was significant for a maternal uncle, who had died at the age of 18 years from sepsis and who was reported to have bronze skin, both of which presumably resulted from unrecognized adrenal insufficiency, and for another maternal uncle, who had been diagnosed with mental illness and was living in an adult residence. In addition, the 70-year-old maternal grandmother had been confined to a wheelchair for almost 15 years due to weakness, the cause of which had not been previously identified. Biochemical studies to detemine VLCFA ratios confirmed the carrier status of the patient s mother and revealed that his only sibling, a 9-year-old brother, had the biochemical defect.Two of his three maternal aunts also were found to be carriers of X-ALD, one of whom was found to have an affected 1-year-old son. 

SY Head. mal. lass, dizz dysp abdom. back pain nau. vomit bronze skin hema jaun peri neur liquid frostbite [care]... 

The symptoms of inhalation of this mixture are not well known. However, Arsine is an extremely toxic gas that destroys red blood cells and can cause widespread organ injury. Inhalation may cause headache, dilirium, nausea, vomiting, general malaise, tightness in the chest, and pain in the abdomen and loins. Arsine may discolor urine to red or a darkened color, and the skin to a bronze or jaundiced color. Symptoms may not occur until several hours after exposure. 

Besides the odor, there may be no other immediate sign that a person is breathing arsine. Its main effect is to destroy red blood cells, causing anemia (destruction of red blood cells) and kidney damage (from red blood cell debris). Within hours after a serious exposure, the victim may develop dark red or brown urine, back pain or belly pain, weakness, or shortness of breath. The skin or eyes may become yellow or bronze in color. Although arsine is related to arsenic, it does not produce the usual signs of arsenic poisoning. 

A 27-year-old man developed a bronze hue to his skin, became jaundiced, and showed signs of disorientation. His liver enzymes were grossly elevated. Ceruloplasmin level was a low normal, but he excreted large amounts of copper in his urine. Propose a reason for this patient s illness, and give the biochemical details. Why is there such severe liver damage What can be done for the patient ... 

Later, look for enlargement of the liver, yellowing of the skin and whites of the eyes, or a bronze appearance to the skin. 

In haemochromatosis, a pronounced brownish pigmentation is found due to the deposition of haemosiderin and melanin in the skin (= bronze diabetes), particularly in the lines of the palm. (s. fig. 4.12) Other predilection sites with distinctive slate-grey pigmentation are the axillae and the inguinal or lumbar region. Occasionally, a brownish ring-shaped discoloration is seen on the prox-... 

Hemochromatosis is a condition in which the body accumulates excess amounts, of iron it is one of the most common genetic diseases in humans. The symptoms of hemochromatosis include the classic triad of bronzing of the skin, cirrhosis, and diabetes. Other manifestations include cardiomyopathies and arrhythmias, endocrine deficiencies, and possibly arthropathies. 

Hypercarotenosis. This occurs from >ive doses of carotene that exceed the ca-city of the mucosa cells to cleave the mole-le to retinal derivatives. The excess carotene ccmes deposited in the body tissues. Except or the yellow or bronze-orange skin, there... 

USE Manuf bronzes, brass other copper alloys, electrical conductors, ammunition, copper salts, works of art, Toxicity Copper itself probably has little or no toxicity although there are conflicting reports in the Literature. Soluble salts notably copper sulfate, are strong irritants to skin, mucous memhranes, Copper oxide fumes can cause metal fume fever. A relationship between copper and hemochromatosis has been reported, See E. Browning, Toxicity of Industrial Metals (Appleton-Century-Crofts, New York 2nd ed, 1969) pp 145-152. 

C. Hemoglobinuria imparts a dark, reddish coiorto the urine, and the skin may deveiop a copper, bronze, or jaundiced discoioration possibiy attributabie to eievated piasma hemogiobin. 

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