Abuse of germanium associated with fatal lactic acidosis

Germanium compounds are marketed as nonprescription drugs in Europe and are recommended by the suppliers for AIDS and metastatic cancer disease. We observed a patient with nonmetastatic breast cancer who died because of severe lactic acidosis (plasma lactate concentration = 27 mmol/l) after ingestio...

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Bibliographic Details
Published inNephron (2015) Vol. 62; no. 3; p. 351
Main Authors Krapf, R, Schaffner, T, Iten, P X
Format Journal Article
LanguageEnglish
Published Switzerland 1992
Subjects
Acidosis - chemically induced
Acute Kidney Injury - chemically induced
Adult
Chemical and Drug Induced Liver Injury
Female
Germanium - poisoning
Humans
Lactates - blood
Lactic Acid
Pancreatitis - complications
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Summary:Germanium compounds are marketed as nonprescription drugs in Europe and are recommended by the suppliers for AIDS and metastatic cancer disease. We observed a patient with nonmetastatic breast cancer who died because of severe lactic acidosis (plasma lactate concentration = 27 mmol/l) after ingestion of 25 g of elemental germanium over a 2-months period. Renal failure and hepatotoxicity had newly developed during germanium intake. Postmortem examination revealed severe hydropic vacuolation of tubule cells and the presence of inclusion bodies predominantly in straight proximal tubule cells with normal appearance of renal interstitium and glomeruli. The liver showed panlobular steatosis. Urine, blood and tissue (kidney, liver, muscle, pancreas) levels of germanium were high. Lactic acidosis may have been caused by the combined, germanium-induced renal and hepatic failure (underutilization), but it remains to be seen whether germanium can affect lactate production and/or metabolism directly.
ISSN:1660-8151
DOI:10.1159/000187072