title: Cadmium encephalopathy: a report with elemental analysis and pathological findings.
abstract: We report a boy of East Indian origin, aged 2 years and 10 months, who died suddenly and unexpectedly. Autopsy findings showed marked cerebral swelling with herniation and histological evidence of marked cerebral edema with perivascular protein leakage, indicating blood-brain barrier disruption. Energy dispersive X-ray microprobe analysis of the brain demonstrated the presence of cadmium and a marked increase in sulfur, predominantly intracellular, both within neuroglial, and to a lesser degree endothelial, cells. Localization was predominantly in the nucleus. Analysis of the kidney showed cadmium deposition in renal tubules and in the basal lamina of podocytes within the glomerulus. Although the environmental source of cadmium remains unknown, we speculate that acute cadmium toxicity led to brain intracellular accumulation with resultant cellular dysfunction, blood-brain barrier disruption, and lethal cerebral edema.
authors.affiliation: Department of Pathology (Division of Neuropathology), Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: J P
authors.initials: JP
authors.lastname: Provias
authors.forename: C A
authors.initials: CA
authors.lastname: Ackerley
authors.forename: C
authors.initials: C
authors.lastname: Smith
authors.forename: L E
authors.initials: LE
authors.lastname: Becker
mesh_terms: D001812:Blood-Brain Barrier; D001927:Brain Diseases / Q000139:chemically induced* / Q000473:pathology; D001929:Brain Edema / Q000139:chemically induced / Q000473:pathology; D002104:Cadmium / Q000009:adverse effects* / Q000032:analysis; D002675:Child, Preschool; D006801:Humans; D007668:Kidney / Q000378:metabolism; D008297:Male; D008668:Metallothionein / Q000378:metabolism
chemical_list: D002104:Cadmium; D008668:Metallothionein