Selenious Acid Toxicity

Aka: Selenious Acid Toxicity, Selenium Poisoning, Selenium Overdose, Gun Blue Ingestion

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II. Background

  1. Selenious Acid is an acidic compound of the element Selenium
    1. Analogous to sulfur in sulfuric Acid (H2SO3), Selenium is the key element in Selenious Acid (H2SeO3)
    2. Selenious Acid forms when Selenium dioxide is added to water
  2. Selenious Acid Industrial Uses (esp. metallurgy, e.g. Gun Blue)
    1. Tints the color of steel to blue (used especially in firearm manufacturing)
    2. Also used to modify the color of other metals (e.g. Copper, brass)
  3. Selenious Acid contains very high Selenium concentrations that may be lethal even in small ingestions
    1. Contrast with the trace quantities of Selenium when taken in Vitamins

III. Mechanism

  1. Sulhydryl-containing enzymes are inhibited by selenious acid
  2. Corrosive Acid
    1. See Caustic Ingestion

IV. Pharmacokinetics

  1. Severe, life threatening toxicity occurs even with low dose ingestions <1 mg/kg
  2. Absorption via ingestion or via skin contact
  3. Inhalation may cause pneumonitis
  4. Half-Life: Days

V. Adverse Effects

  1. Gastrointestinal
    1. Nausea or Vomiting
    2. Foul Garlic odor to the breath
    3. Diarrhea
    4. Mucosal burns
    5. Hemorrhagic Gastritis
  2. Muscular
    1. Muscle Weakness
    2. Acute Respiratory Failure (Bellows Failure)
  3. Cardiac
    1. Chest Pain
    2. Hypotension
    3. EKG Abnormalities
      1. QTc Prolongation
      2. Ventricular Dysrhythmia
  4. Respiratory
    1. Dyspnea
    2. Hypoxia
    3. Edema

VI. Labs

  1. See Unknown Ingestion
  2. Serum Selenium level

VII. Management

  1. Supportive Care
    1. Intravenous Fluids
    2. Vasopressors for refractory shock
  2. Endoscopy
    1. Gastrointestinal Hemorrhage and other complications
  3. Other measures to consider (unclear benefit)
    1. Chelation therapy (dimercaprol or CalciumSodium EDTA)
    2. Hemodialysis
  4. Disposition
    1. May disposition home if no symptoms (including gastrointestinal) at 6 hours after exposure

VIII. References

  1. Tomaszewski (2023) Crit Dec Emerg Med 37(7): 32
  2. Nuttall (2006) Ann Clin Lab Sci 36(4): 409-20
    1. http://www.annclinlabsci.org/content/36/4/409.long

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