Intoxication by Self-administered Cesium Salts, the Clinical Impact of Questionable Research Output

自行服用铯盐中毒:可疑研究成果的临床影响

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Abstract

Cesium chloride (CsCl) is a non-radioactive salt wrongly promoted and used as part of an alternative cancer treatment based on questionable research output published in the mid-eighties. Self-administered cesium can lead to various symptoms. We analyzed the complete set of published case reports of people who have taken cesium to characterize demographics, reasons for intake, clinical effects, reported symptoms, pathophysiology, treatment options, and outcomes, followed by a historical and critical note. A total of 20 cases were included in this literature review. Most patients were females (n = 14), and almost half of the patients were between 40 and 49 years. Most patients used cesium as an alternative treatment for cancer (n = 15). When the route of administration was mentioned, it was most often oral, followed by intravenous use and combined routes. Symptoms occurred across multiple organ systems, including the cardiovascular, neuromuscular and gastrointestinal system. When ECG results were presented, QT prolongation, followed by sinus bradycardia and Torsade de Pointes arrhythmias were most often described. A wide variety of treatments have been provided to the patients. Five patients were reported to have died because of the cesium intake. After absorption, cesium is distributed throughout the body, where it inhibits ion channels, mainly for potassium. These channels, particularly in cardiac cells, are crucial for maintaining normal electrophysiology. The improper promotion of self-administration of cesium as part of an alternative cancer treatment, based on uncorrected scientific misinformation may result in life-threatening cardiac arrhythmia.

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