II. Background
- Selenious Acid is an acidic compound of the element Selenium
- Selenious Acid Industrial Uses (esp. metallurgy, e.g. Gun Blue)
- Tints the color of steel to blue (used especially in firearm manufacturing)
- Also used to modify the color of other metals (e.g. copper, brass)
- Selenious Acid contains very high Selenium concentrations that may be lethal even in small ingestions
III. Mechanism
- Sulhydryl-containing enzymes are inhibited by selenious acid
- Corrosive Acid
IV. Pharmacokinetics
- Severe, life threatening toxicity occurs even with low dose ingestions <1 mg/kg
- Absorption via ingestion or via skin contact
- Inhalation may cause pneumonitis
- Half-Life: Days
V. Adverse Effects
- Gastrointestinal
- Nausea or Vomiting
- Foul Garlic odor to the breath
- Diarrhea
- Mucosal burns
- Hemorrhagic Gastritis
- Muscular
- Cardiac
- Chest Pain
- Hypotension
- EKG Abnormalities
- QTc Prolongation
- Ventricular Dysrhythmia
- Respiratory
VI. Labs
- See Unknown Ingestion
- Serum Selenium level
VII. Management
- Supportive Care
- Intravenous Fluids
- Vasopressors for refractory shock
- Endoscopy
- Gastrointestinal Hemorrhage and other complications
- Other measures to consider (unclear benefit)
- Chelation therapy (dimercaprol or CalciumSodium EDTA)
- Hemodialysis
- Disposition
- May disposition home if no symptoms (including gastrointestinal) at 6 hours after exposure
VIII. References
- Tomaszewski (2023) Crit Dec Emerg Med 37(7): 32
- Nuttall (2006) Ann Clin Lab Sci 36(4): 409-20