Clinical findings:
(1) acute chemical burns on contact (skin, oral, gastrointestinal)
(2) acute renal failure
(3) acute gastrointestinal symptoms (nausea, vomiting, diarrhea, bleeding)
(4) late gastrointestinal complications years later (perforation, stricture)
(5) keratitis and conjunctivitis with ocular exposures
(6) multi-organ failures with severe intoxications (hepatic failure, pulmonary edema, coagulopathy, hemolysis, shock)
Even a relatively small chemical burn can be fatal if sufficient chromium is absorbed to cause organ failure.
Differential diagnosis: exposure to bivalent or trivalent chromium, which are much less toxic.
