Because laboratory investigations are often inconclusive, any unexplained peripheral neuropathy, particularly if accompanied by baldness, should arouse clinical suspicion for thallium poisoning. Begin therapy for individuals with a strong suspicion of thallium poisoning in conjunction with a medical toxicologist while waiting for test confirmation.
The only way to establish a definite clinical diagnosis of thallium poisoning is to show high thallium levels. Thallium may be found in hair, nails, feces, saliva, blood, and urine.
All individuals with substantial thallium poisoning signs or symptoms must be hospitalized. The following are the goals of thallium poisoning treatment:
- Initial stabilization – check ABCs (Airway, Breathing, Cardiovascular system) and provide oxygen if required; eliminate the cause of contamination or dirty clothes if feasible.
- Decontamination – cause puking if consumed within the past thirty min. Consider using activated carbon and Prussia blue to decontaminate the stomach. When the skin is exposed, wash the affected skin thoroughly using water and soap.
- Follow-up – thallium poisoning in the blood or urine should be measured three to four times a week. Prussian blue treatments should be maintained until the 24-hour urine thallium content recovers to the recommended ranges (0-5 mcg/d).
The essential to recovery from thallium is early detection and therapy. Missed therapy increases the likelihood of chronic nerve damage complaints and neurological and cognitive problems. Recovery might take years, and full recovery is never attained in some situations.