Bromism from excessive cola consumption

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Background: Bromism is an unusual occurrence. Historically bromism has been known to occur with chronic ingestion of bromide salts used as sleep medications. In this case, excessive consumption of a cola with brominated vegetable oil caused a severe case of bromism. Case Report: The patient presented with headache, fatigue, ataxia, and memory loss which progressed over 30 days. He consumed 2 to 4 L of cola containing brominated vegetable oil on a daily basis before presenting with these symptoms. His significantly elevated serum chloride, as measured by ion specific methods, and negative anion gaps were overlooked during a prior hospitalization and emergency department visits. A focal neurologic finding of right eyelid ptosis led to an extensive evaluation for a central nervous system lesion. The patient continued to deteriorate, until he was no longer able to walk. A diagnosis of severe bromism was eventually made and his serum bromide was confirmed at 3180 mg/L (39.8 mmol/L). Despite saline loading the patient failed to improve but subsequent hemodialysis dramatically cleared his clinical condition, and reduced his serum bromide levels. The unilateral eyelid ptosis, a rarely reported finding in bromism, also resolved with hemodialysis. Conclusions: A negative anion gap or an elevated serum chloride should prompt an evaluation for bromism. In this case hemodialysis dramatically improved the patient's clinical condition and reduced the half-life of bromide to 1.38 h.

Original languageEnglish (US)
Pages (from-to)315-320
Number of pages6
JournalJournal of Toxicology - Clinical Toxicology
Volume35
Issue number3
StatePublished - 1997
Externally publishedYes

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Bromides
Blepharoptosis
Renal Dialysis
Plant Oils
Acid-Base Equilibrium
Serum
Chlorides
Memory Disorders
Neurology
Ataxia
Neurologic Manifestations
Fatigue
Headache
Half-Life
Hospital Emergency Service
Sleep
Hospitalization
Central Nervous System
Salts
Eating

ASJC Scopus subject areas

  • Toxicology
  • Health, Toxicology and Mutagenesis

Cite this

Bromism from excessive cola consumption. / Horowitz, B (Zane).

In: Journal of Toxicology - Clinical Toxicology, Vol. 35, No. 3, 1997, p. 315-320.

Research output: Contribution to journalArticle

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