Successful management of germanium poisoning-induced multiple organ dysfunctions by combined blood purification therapy

Abstract

Background

Blood purification therapy has not been applied in the detoxification of germanium compounds. This report described a case of germanium poisoning with renal failure, liver dysfunction, and acute pancreatitis which was successfully treated by continuous venovenous hemodiafiltration (CVVHDF) combined with plasmapheresis.

Case report

A 58-year-old male was admitted to a local hospital due to polydipsia, polyuria, and weight loss for 2 months. The patient was definitely diagnosed with germanium poisoning and was treated with blood purification therapy, CVVHDF combined with plasmapheresis. The blood and urinary germanium concentrations decreased rapidly during the first week after the combined blood purification therapy. The blood germanium concentration gradually reduced to within the normal range within the next three weeks and fluctuated at a normal level. However, the urinary germanium concentration exceeded the normal level after three months, indicating an accumulation of germanium in the organs and tissues. The patient’s clinical symptoms ameliorated and the functions of kidney, liver and pancreatitis gradually recovered.

Conclusion

Combined CVVHDF with plasmapheresis is an effective treatment for germanium poisoning and the associated multiple organ dysfunctions.

Keywords:

• Germanium poisoning
• multiple organ dysfunction
• continuous venovenous hemodiafiltration (CVVHDF)
• plasmapheresis

Transparency

Declaration of funding

This work is supported by a National Natural Science Foundation of China grant (81600236) provided to Luyun Wang and the Natural Science Foundation of Guangdong grant (2016A030313357) and the Science and Technology Planning Project of Guangdong grant (2016A020215215) provided to Changlong Zheng.

Declaration of financial/other relationships

The authors and peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

DZ and CZ wrote the paper. LW provided the case data and revised the manuscript. All authors reviewed the manuscript and approved the final version of the manuscript.

Acknowledgements

We gratefully acknowledge Professor Daowen Wang (Intensive Care Unit, Division of Cardiology, Department of Internal Medicine, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology) for critically reviewing and editing this manuscript.