High silver concentrations in biological samples following different exposures: Two case reports.


Journal

Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS)
ISSN: 1878-3252
Titre abrégé: J Trace Elem Med Biol
Pays: Germany
ID NLM: 9508274

Informations de publication

Date de publication:
Sep 2021
Historique:
received: 30 11 2020
revised: 29 03 2021
accepted: 04 05 2021
pubmed: 14 5 2021
medline: 30 11 2021
entrez: 13 5 2021
Statut: ppublish

Résumé

Silver is used in various industrial applications, but also in confectioneries and for therapeutic use due to its antibiotic properties. Its toxicity is not well documented and most often only in the context of professional exposure. Here we report two cases of high silver concentrations in biological samples in two women: the first patient presented grey marks around her cuticles, probably due to her consumption of silvered sweets and the second patient presented agranulocytosis and thrombocytopenia occurring within 24 h after the topical application of a cream containing sulfadiazine and silver to burns over a large surface area. Silver concentrations were determined in blood and urine samples and sweets using inductively coupled plasma- mass spectrometry (ICP-MS). The silver concentrations were elevated compared to population reference values and confirmed the hypotheses for the patients: the significant consumption of sweets coated with silver nanoparticles and the topical application of a cream containing silver to burns over a large area. After initial questioning by the dermatologist, Patient 1 explained that she consumed more than 30 bags of the sweets per year. She decreased her consumption of the sweets and the control performed one year later showed a plasma silver concentration of 1.5 μg/L. For Patient 2, the absorption of silver through burns over a large area appeared relatively significant, whereas it is very low through undamaged skin. The haematological cells counts returned to normal levels quickly and no other major effects were highlighted. To apply these findings to a larger population, further investigation to determine sulfadiazine and silver concentrations in plasma and urine have been initiated in a cohort of patients with burns over a large area.

Sections du résumé

BACKGROUND BACKGROUND
Silver is used in various industrial applications, but also in confectioneries and for therapeutic use due to its antibiotic properties. Its toxicity is not well documented and most often only in the context of professional exposure.
AIM OBJECTIVE
Here we report two cases of high silver concentrations in biological samples in two women: the first patient presented grey marks around her cuticles, probably due to her consumption of silvered sweets and the second patient presented agranulocytosis and thrombocytopenia occurring within 24 h after the topical application of a cream containing sulfadiazine and silver to burns over a large surface area.
METHODS METHODS
Silver concentrations were determined in blood and urine samples and sweets using inductively coupled plasma- mass spectrometry (ICP-MS).
RESULTS RESULTS
The silver concentrations were elevated compared to population reference values and confirmed the hypotheses for the patients: the significant consumption of sweets coated with silver nanoparticles and the topical application of a cream containing silver to burns over a large area.
DISCUSSION-CONCLUSION CONCLUSIONS
After initial questioning by the dermatologist, Patient 1 explained that she consumed more than 30 bags of the sweets per year. She decreased her consumption of the sweets and the control performed one year later showed a plasma silver concentration of 1.5 μg/L. For Patient 2, the absorption of silver through burns over a large area appeared relatively significant, whereas it is very low through undamaged skin. The haematological cells counts returned to normal levels quickly and no other major effects were highlighted. To apply these findings to a larger population, further investigation to determine sulfadiazine and silver concentrations in plasma and urine have been initiated in a cohort of patients with burns over a large area.

Identifiants

pubmed: 33984545
pii: S0946-672X(21)00065-1
doi: 10.1016/j.jtemb.2021.126775
pii:
doi:

Substances chimiques

Sulfadiazine 0N7609K889
Silver 3M4G523W1G
Silver Sulfadiazine W46JY43EJR

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

126775

Informations de copyright

Copyright © 2021 Elsevier GmbH. All rights reserved.

Auteurs

Benedicte Lelievre (B)

Laboratoire de pharmacologie-toxicologie, CHU Angers, France; Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP) EA 3142, Université d'Angers-Université de Brest, Angers, France. Electronic address: belelievre@chu-angers.fr.

Anne-Charlotte Tellier (AC)

Service de réanimation chirurgicale, CHU Tours, France.

Gabriel Colonna (G)

Cabinet de dermatologie, Porto Vecchio, France.

Benjamin Cohen (B)

Service de réanimation des brûlés, CHU Tours, France.

Yoann Cazaubon (Y)

Laboratoire de pharmacologie-toxicologie, CHU Reims, France.

Frederic Leccia (F)

Centre médical, Porto Vecchio, France.

François Darrouzain (F)

Laboratoire de pharmacologie-toxicologie, CHU Tours, France.

Marie Deguigne (M)

Centre anti-poison-toxicovigilance, CHU Angers, France.

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Classifications MeSH