Ver el código de «Silver toxicity»

==Background==
* Silver exposure is typically seen in workplace environments, herbal supplements, and other products
* Exposure is usually topical, but can also include inhalation, and ingestion
*Common work place environments include
**Silver nitrate manufacturing
***Used in manufacturing mirrors, inks, dyes, germicides, antiseptics, and analytical reagents
*Other possible sources of exposure
**Acupuncture needles
**Silver jewelry
**Herbal supplements
**Silver sulfadiazine

==Clinical Features==
*Typically occur as chronic exposure
*Skin discoloration (Argyria)
**Permanent bluish-gray discoloration thought to be due to increased melanin production

===Significant Toxicity===
*Rare
*50 mg IV is considered fatal
*Thought to be related to blockade of Na-K-ATPase
*Pulmonary Edema
*Hemorrhage
*Necrosis of bone marrow, liver, and kidneys

==Differential Diagnosis==
{{Heavy metals list}}

==Evaluation==
*Usually a clinical diagnosis
*Serum and urine levels can be sent
**Serum <1 µg/L (<9 nmol/L)
**Urine (24 hour) <2 µg/L (<18 nmol/L)

==Management==
*Argyria
**Topical hydroquinone 5%
**Sunscreen to prevent further pigmentation
*Silver Ingestion
**Supportive Care
*Silver salt ingestion
**treat as [[caustic ingestion]]
*Burns from silver salt
**treat as chemical [[burns]]

==Disposition==
*Discharge unless shows signs of systemic toxicity

==References==
<references/>
Lai Becker M., Burns Ewald M. Silver. In: Goldfrank's Toxicologic Emergencies. 9th Ed. New York: McGraw-Hill; 2011: 1321-1325

[[Category:Toxicology]]