HEPATITIS AND NEPHROSIS DUE TO SOLUBLE BISMUTH

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Abstract
An instance of jaundice, abdominal pain and anuria due to administration of sodium bismuth thioglycolate (thiobismol®) with liver and kidney damage is reported. The great toxicity of the water soluble preparation of this heavy metal in this and other similiar cases is stressed. Attention is drawn to the use of BAL therapy in the early or first phase, to the need for caution in fluid administration in cases of lower nephron nephrosis caused by bismuth during the anuric and oliguric phases, and to the need for covering the loss of fluid and electrolytes in the subsequent diuretic phase. The use of soluble bismuth preparations should be limited to specific conditions and only to those cases which fail to respond to less toxic drugs.

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