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Bismuth encephalopathy- a rare complication of long-standing use of bismuth subsalicylate

2019-08-29Artigo científico Acesso aberto
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dc.contributor.authorBorbinha, Cláudia
dc.contributor.authorSerrazina, Filipa
dc.contributor.authorSalavisa, Manuel
dc.contributor.authorViana-Baptista, Miguel
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.institutionCentro de Estudos de Doenças Crónicas (CEDOC)
dc.contributor.pblSpringer Nature
dc.date.accessioned2019-09-16T22:43:12Z
dc.date.available2019-09-16T22:43:12Z
dc.date.issued2019-08-29
dc.description.abstractBackground: Drugs containing bismuth, although usually safe, may rarely cause neurotoxicity. Case presentation: We describe the case of a 44-year-old woman treated with bismuth subsalicylate for about 20 years, who developed abnormal behaviour and postural instability in two weeks. On examination, she had greyish discoloration of teeth, was confused and presented generalized myoclonic jerks. In the next days, her clinical condition deteriorated, with a reduction in alertness and more exuberant myoclonus. Brain MRI was unremarkable. CSF revealed mild elevation of protein content (47 mg/dL; reference range: 15-45 mg/dL) and elevation of white blood cell count (10/μL). Bismuth levels in urine (375 μg/L), serum (260 μg/L) and CSF (21.4 μg/L) samples were highly above the threshold for toxicity. Following supportive treatment and bismuth discontinuation, she made a full recovery within weeks. Conclusions: Although rare, bismuth encephalopathy should be considered in patients presenting with subacute encephalopathy and myoclonus. This encephalopathy can be subacute even after a chronic exposure. Cessation of bismuth can lead to a complete resolution in weeks.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent609599
dc.identifier.doi10.1186/s12883-019-1437-9
dc.identifier.issn1471-2377
dc.identifier.otherPURE: 14704542
dc.identifier.otherPURE UUID: edaefa6f-e5df-4b52-b02c-cc15c0007939
dc.identifier.otherScopus: 85071608123
dc.identifier.otherPubMed: 31464594
dc.identifier.otherWOS: 000483575000002
dc.identifier.urihttp://www.scopus.com/inward/record.url?scp=85071608123&partnerID=8YFLogxK
dc.identifier.urlhttps://www.scopus.com/pages/publications/85071608123
dc.language.isoeng
dc.peerreviewedyes
dc.subjectBismuth subsalicylate
dc.subjectEncephalopathy
dc.subjectMyoclonus
dc.subjectNeurotoxicity
dc.subjectClinical Neurology
dc.titleBismuth encephalopathy- a rare complication of long-standing use of bismuth subsalicylateen
dc.typejournal article
degois.publication.issue1
degois.publication.titleBMC Neurology
degois.publication.volume19
dspace.entity.typePublication
rcaap.rightsopenAccess

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