Elevated urinary cadmium concentrations in a patient with acute cadmium pneumonitis.

Abstract

Acute serious inhalation of cadmium fumes often causes chemical pneumonitis or metal fume fever. Because symptoms of both diseases begin several hours after exposure and closely mimic each other, one often mistakes chemical pneumonitis for metal fume fever in the early stages. It is, however, essential to differentiate between the two since chemical pneumonitis can progress to serious consequences. A 43-year-old man was admitted to the hospital 2 d after exposure to cadmium fumes. The initial diagnosis was metal fume fever on the basis of his history, and he was treated accordingly. His symptoms worsened however, and transient renal impairment was identified as consistent with cadmium-induced renal toxicity. Although the possibility of drug-induced renal damage could not be excluded, abnormal urinalysis findings on admission suggested that the renal tubular damage was caused by inhaled cadmium before admission. Measuring the urinary cadmium concentration is an effective method for confirming acute cadmium poisoning.