bromism

Bromism is a medical term for poisoning caused by bromide ions, typically from ingestion or exposure to bromide salts or brominated compounds. Historically, bromide salts such as sodium bromide and potassium bromide were used as sedatives and anticonvulsants, and bromism was a more common clinical concern. Today, bromism is rare but can occur with continued exposure or impaired elimination.

Bromide ions are excreted mainly by the kidneys and are chemically similar to chloride. As a result, bromide can accumulate in the body with prolonged dosing or high exposure, especially in individuals with reduced renal function. The elimination half-life of bromide is long, taking days to weeks, which allows toxicity to develop and persist if exposure continues. Removal of bromide often requires cessation of exposure and, in severe cases, procedures to accelerate elimination, such as dialysis.

Clinical features of bromism are broad and reflect central nervous system depression and dermatologic reaction. Neurologic symptoms include confusion, irritability, dizziness, ataxia, tremor, slurred speech, and, in severe cases, stupor or coma. Mood changes and cognitive slowing can occur. A characteristic skin finding, bromoderma, may present as acneiform or pustular lesions with ulceration. Other signs may include halitosis and bromide in the urine (bromuria). The severity generally correlates with serum bromide levels and duration of exposure.

Diagnosis relies on a compatible exposure history and laboratory confirmation of elevated serum bromide concentrations. Management centers on stopping exposure and supporting care; hydration and diuresis may help, and hemodialysis is considered for severe cases or when renal function is compromised to rapidly lower bromide levels. Bromism is largely historical today but remains important in contexts of unusual exposure or renal impairment.