Encephalopathy associated with bismuth subgallate therapy.
A 74-year-old man developed paranoid ideation, memory impairment, and defective gustatory and olfactory function while on bismuth subgallate therapy for use as a colostomy deodorant. Twenty-four-hour urine bismuth was elevated at 889 micrograms/day, and whole blood bismuth concentration was 67 micrograms/L. The patient improved after discontinuation of bismuth subgallate; there was resolution of paranoid behavior and gustatory and olfactory functions improved. Follow-up whole blood bismuth concentration was 21 micrograms/L 4 weeks after cessation. Altered gustatory and olfactory function have not been previously reported with bismuth intoxication.
Friedland
R P
RP
Department of Neurology, University Hospitals of Cleveland, Case Western Reserve University, Ohio 44106.
Lerner
A J
AJ
Hedera
P
P
Brass
E P
EP
D000368:Aged; D000890:Anti-Infective Agents / Q000009:adverse effects*; D048909:Diabetes Complications; D005707:Gallic Acid / Q000009:adverse effects / Q000031:analogs & derivatives*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D001523:Mental Disorders / Q000139:chemically induced*; D009942:Organometallic Compounds / Q000009:adverse effects*; D011569:Psychiatric Status Rating Scales; D012678:Sensation Disorders / Q000139:chemically induced; D012903:Smell / Q000187:drug effects; D013649:Taste / Q000187:drug effects
D000890:Anti-Infective Agents; D009942:Organometallic Compounds; D005707:Gallic Acid; C002170:bismuth subgallate