Clinical Findings in Bromism (Bromide Intoxication)

 

molecular weight: 79.9 grams

normal half-life: 10-12 days

 

Risk factors:

(1) high intake of a bromide

(2) impaired renal function (decreased excretion with accumulation)

(3) elderly

 

Sources of bromide:

(1) over the counter medications containing bromide or hydrobromide

(2) brominated vegetable oils (which may be present in some soft drinks)

(3) pesticide methyl bromide

(4) brominated pool or spa disinfectant

(5) prescription medications with bromide (halothane hydrobromide, etc)

(6) breast-fed infants if the mother with excessive bromide intake

 

Clinical findings:

(1) skin lesions, including bromoderma

(2) gastrointestinal complaints (vomiting, anorexia, nausea, gastroenteritis)

(3) fever

(4) neurologic disorders (headache, depressed level of consciousness including coma, slurred speech, ataxia, disturbances in memory, tremors, hyporeflexia, nystagmus, pseudotumor cerebri, hypotonia)

(5) psychiatric complaints (auditory and/or visual hallucinations, depression, dementia, senility, confusion, mania)

(6) hypothyroidism

(7) postnatal growth retardation

 

Laboratory findings:

(1) pseudohyperchloremia

(2) negative anion gap

(3) black stools

Serum Level	Clinical Correlate
< 6.3 mmol/L	therapeutic
6.3 - 12.4 mmol/L	mild to moderate toxicity
12.5 - 24.9 mmol/L	severe toxicity
>= 25 mmol/L	coma
>= 37.5 mmol/L	fatal

 

where:

• 10 µg/mL = 10 mg/L = 1 mg/dL = 0.125 mmol/L = 0.125 mEq/L