Reversible leukoencephalopathy associated with organotin poisoning

Abstract

Introduction

Organotin compounds are widely used in the plastic industry. We demonstrate the role of brain magnetic resonance imaging in a patient with leukoencephalopathy.

Clinical course

A 38-year-old man who worked with trimethyltin and dimethyltin in a polyvinyl chloride factory reported a two-week progression of impaired memory, loss of balance, apathy, tinnitus, scaly darkened skin, and psychomotor slowing that rendered him unable to continue his daily activities. Magnetic resonance imaging revealed diffuse bilateral white matter lesions. Tin concentrations in both blood (344 μ/L) and urine (3,050 μg/L) were elevated. Removal from exposure and treatment with succimer were associated with clinical, laboratory, and imaging improvements.

Discussion

The high lipid content of myelin is a likely target for lipid-soluble alkyl tin compounds.

Conclusions

This patient demonstrates the clinical and magnetic resonance imaging findings of organotin toxicity. The contribution of chelation to the patient's recovery is uncertain and warrants further study.

Keywords:

• Organotin
• leukoencephalopathy
• magnetic resonance imaging

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.