Cadmium toxicity: Difference between revisions

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****Reduced total body iron stores leads to upregulation of the gene that encodes for DMT1, a heavy metal transporter located on the luminal side of enterocytes. Consequently, more cadmium is absorbed from the gastrointestinal tract. <ref> Traub, S., & Elinder, C. (2017). Epidemiology and toxicity of cadmium. In G. Curhan (Ed.), UpToDate. UpToDate, Waltham, MA, (Accessed on February 22, 2018). </ref>
****Reduced total body iron stores leads to upregulation of the gene that encodes for DMT1, a heavy metal transporter located on the luminal side of enterocytes. Consequently, more cadmium is absorbed from the gastrointestinal tract. <ref> Traub, S., & Elinder, C. (2017). Epidemiology and toxicity of cadmium. In G. Curhan (Ed.), UpToDate. UpToDate, Waltham, MA, (Accessed on February 22, 2018). </ref>
**Dermal (less than 1%)
**Dermal (less than 1%)
*Distribution
**Once absorbed, cadmium distributes to most major organs, however it has a predilection for the liver and kidneys


===Mechanism of Toxicity===
===Mechanism of Toxicity===

Revision as of 18:27, 26 February 2018

Background

  • Used in electroplating, soldering, pigments, and plastics
  • Routes of exposure:
    • Inahlation (up to 25%)
      • Cigarette smoking, occupational exposure
    • Gastrointestinal (1-10%)
      • Cadmium is ubiquitous in food systems
      • Total daily amount ingested is influenced by a variety of factors
        • Reduced total body iron stores leads to upregulation of the gene that encodes for DMT1, a heavy metal transporter located on the luminal side of enterocytes. Consequently, more cadmium is absorbed from the gastrointestinal tract. [1]
    • Dermal (less than 1%)
  • Distribution
    • Once absorbed, cadmium distributes to most major organs, however it has a predilection for the liver and kidneys

Mechanism of Toxicity

  • Inhaled form is 60 times more toxic than ingested form
  • Chemical pneumonitis
  • Pulmonary edema/hemorrhage
  • GI irritation
  • Renal tubule damage

Clinical Features

Differential Diagnosis

Evaluation

  • History of exposure and respiratory / gastrointestinal complaints

Management

Inhalation

  • Supplemental oxygen
  • Monitor ABG, check CXR
  • Treat wheezing and pulmonary edema

Ingestion

  • Activated charcoal or lavage
  • Volume resuscitation to counter fluid losses
  • No role for hemodialysis

Disposition

See Also

References

Olson, K. Poisoning and Drug Overdose, 1999.

  1. Traub, S., & Elinder, C. (2017). Epidemiology and toxicity of cadmium. In G. Curhan (Ed.), UpToDate. UpToDate, Waltham, MA, (Accessed on February 22, 2018).