Shohini Mukerji¹, Joanna Lee²

¹Chemical Pathology Department, Royal North Short Hospital, St Leonards, NSW, Australia 

²Royal North Short Hospital, St Leonards, NSW, Australia 

 

 

A male in his 70s presented to the Emergency Department with L3 radiculopathy limiting his mobility, along with concurrent nausea and anorexia. He was incidentally noted to have blue finger nailbeds. Further questioning revealed a history of having ingested a home-made colloidal silver preparation approximately six weeks prior. Inductively coupled plasma mass spectrometry measurement of whole blood silver levels indicated an increased blood silver concentration at 13.6 ug/L (reference interval < 0.3 ug/L). Management included counselling on abstinence and monitoring for other organ involvement in liaison with the Dermatology team and Toxicologist. Argyria may be diagnosed clinically based on history and examination, however in some cases laboratory testing may be requested to support the diagnosis.^1,2 This case highlights the importance of a thorough clinical examination, the limited data available on the interpretation of whole blood silver concentrations and the potential harm that may be caused by misinformation on the internet describing colloidal silver solutions as an alternative treatment.³

 

                                                                                       

1.      Kim JJ, Konkel K, McCulley L, Diak I-L. Cases of Argyria Associated With Colloidal Silver Use. Annals of Pharmacotherapy. 2019;53(8):867-870. 

2.      Mota L, Dinis-Oliveira RJ. Clinical and Forensic Aspects of the Different Subtypes of Argyria. J Clin Med. 2021 May 13;10(10):2086. 

3.      Leino V, Airaksinen R, Viluksela M, Vähäkangas K. Toxicity of colloidal silver products and their marketing claims in Finland. Toxicol Rep. 2020 Dec 26;8:106-113.

Author Contribution Statement: SM conceived the idea for this case to be described in in a case report with a focus on providing a perspective for the laboratory audience. JL was involved in the clinical care of this patient, summarised the details of the clinical case and has previously presented the clinical case as an oral case presentation. SM captured photographs of the case for the poster. SM prepared the abstract and poster initial drafts. JL has reviewed and contributed to the text of both.