Molecular weight: 204.38
Atomic number: 81
Exposures:
(1) rodenticides
(2) optical or electronic industries
(3) chemical research
Typical routes of absorption:
(1) ingestion
(2) inhalation
Classic triad:
(1) gastroenteritis (with nausea, vomiting, diarrhea, abdominal pain, hematochezia, severe constipation)
(2) alopecia
(3) polyneuropathy (with weakness, tremor, ataxia and intense distal hyperesthesia)
Additional findings:
(1) CNS toxicity (optic neuritis, ptosis, confusion, memory loss, altered mental status)
(2) anxiety, depression and/or psychosis
(3) gingival hyperpigmentation
(4) hyperpigmentation of the hair
(5) tachycardia and chest pain
(6) diffuse rash
(7) Mees lines (late)
Laboratory findings:
(1) elevated whole blood thallium levels
(2) elevated urinary thallium concentration (in a 24 hour urine collection)
(3) anemia and thrombocytopenia
(4) elevated liver function tests
Differential diagnosis:
(1) other heavy metal poisonings (mixed exposures may occur)
(2) Guillain-Barre syndrome
(3) acute porphyria
