title: Acute aluminum toxicity associated with oral citrate and aluminum-containing antacids.
abstract: The authors report the development of a rapidly progressive encephalopathy marked by confusion, myoclonus, seizures, coma, and death in a group of women with renal failure who received an oral solution of citrate and aluminum hydroxide gel concurrently. Two patients were documented as having marked hyperaluminemia far exceeding blood aluminum levels encountered in the chronic state of aluminum intoxication. We ascribe the toxicity to enhanced gastrointestinal absorption of aluminum when complexed with citrate.
authors.affiliation: Department of Medicine, Medical College of Virginia, Richmond 23298-0160.
authors.forename: B B
authors.initials: BB
authors.lastname: Kirschbaum
authors.forename: A C
authors.initials: AC
authors.lastname: Schoolwerth
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications / Q000628:therapy; D000368:Aged; D000535:Aluminum / Q000097:blood / Q000506:poisoning*; D000536:Aluminum Hydroxide / Q000009:adverse effects*; D002951:Citrates / Q000009:adverse effects*; D019343:Citric Acid; D003128:Coma / Q000139:chemically induced; D048909:Diabetes Complications; D004347:Drug Interactions; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D007408:Intestinal Absorption; D008875:Middle Aged; D006435:Renal Dialysis
chemical_list: D002951:Citrates; D019343:Citric Acid; D000536:Aluminum Hydroxide; D000535:Aluminum