Experimental bases for ascorbic acid therapy of poisoning by hexavalent chromium compounds

Abstract

The most frequent outcome of the usually transdermal absorption of hexavalent chromium compounds is uraemia due to tubular necrosis. We have confirmed earlier observations that this can be prevented by the immediate application of ascorbic acid (AA) with the aim of reducing Cr(VI) to Cr(III). The spontaneous reducing capacity of samples of serum and plasma for Cr(VI) compounds was polarographically determined to be about 2 ppm. Addition of AA in doses of 50 to 1000 ppm led to a rapid and dose-dependent reduction of chromium(VI), which was studied on the concentration level of 5 ppm. For example in the presence of 1000 ppm AA, five ppm chromium(VI) fade to 0.7 ppm within 20 min and to undetectable concentrations after 40 min. These experiments demonstrate the effectiveness of AA for the treatment of Cr(VI) poisoning. Reduction is increased and accelerated by AA and the resulting Cr(III)-protein complexes are non-toxic and can be excreted with the urine. Early and repeated high i.v. doses of AA are recommended as the therapy of choice for Cr(VI) poisoning. In cases of delayed medical treatment, AA should be immediately applied orally.

Metabolic reduction of chromium by alveolar macrophages and its relationships to cigarette smoke.

“…For instance, Cr(VI) is reduced in human plasma (9) and inside erythrocytes (10, 1 1), this being in agreement with the finding that chromium typically produces tumors at implant sites (1). Saliva and especially gastric juice are also quite effective in reducing Cr(VI) ( 12), thus constituting a hardly surmountable barrier to the metal introduced by the oral route or swallowed after reflux from the respiratory tract.…”

Chromium (VI) reducing capacity of ascorbic acid and of human plasma in vitro

“…The concentration in erythrocytes has been proposed as a means of biological monitoring. On the other hand, a part of chromium(VI) is reduced in the plasma (Korallus et al 1984). The resulting Cr(III) is bound to macromolecules, e. g. albumin, or to low molecular weight compounds, and is finally excreted in the urine (Wada et al 1983;Wiegand et al 1985;Yamamoto et al 1989) The extracellular reduction of Cr(VI) is considered to represent a detoxification mechanism.…”

“…Ascorbic acid is an effective antidote in acute chromate poisoning (Korallus et al 1984). Ascorbic acid, as a constituent of lung lavage fluids, detoxifies inhaled Cr(VI) by reduction (Suzuki 1988;Suzuki and Fukuda 1990).…”

Acute Potassium Dichromate Poisoning Presenting With Myocarditis and Uretheral Injuries: A Case Report

“…Based on this observation oral ascorbic acid and gastric lavage with ascorbic acid has been tried in treatment of potassium dichromate poisoning as ascorbic acid fastens the conversion of hexavalent chromate to trivalent chromate. 5 Other treatment modalities like hemodialysis and charcoal hemoperfusion have been tried but not with much success. 6 A case successfully treated with peritoneal dialysis has been reported.…”