Bromism is the chemical intoxication that occurs following intentional or accidental intake of bromide.
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
Specialty: Toxicology, Emergency Medicine, Critical Care