Thallium is a soft metal that quickly oxidizes upon exposure to air. It is a minor constituent in a variety of ores. Thallium salts are used in the manufacture of jewelry, semiconductors, and optic devices. Thallium no longer is used in the United States as a depilatory or rodenticide because of its high human toxicity.

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   Mechanism of toxicity. The mechanism of thallium toxicity is not known. It appears to affect a variety of enzyme systems, resulting in generalized cellular poisoning. Thallium metabolism has some similarities to that of potassium, and it may inhibit potassium flux across biologic membranes by binding to Na+/K+-ATP transport enzymes.

   
   
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   Toxic dose. The minimum lethal dose of thallium salts is probably 12–15 mg/kg, although toxicity varies widely with the compound, and there have been reports of death after adult ingestions of as little as 200 mg. The more water-soluble salts (eg, thallous acetate and thallic chloride) are slightly more toxic than the less soluble forms (thallic oxide and thallous iodide). Some thallium salts are well absorbed across intact skin.

   
   
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   Clinical presentation. Symptoms do not occur immediately but are typically delayed 12–14 hours after ingestion.

   
   
   
   
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      Acute effects

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