Generalized argyria in two chronic hemodialysis patients

Yuh Mou Sue, J. Yu-Yun Lee, Ming Cheng Wang, Tzu Kai Lin, Junne Ming Sung, Jeng Jong Huang

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23 Citations (Scopus)

Abstract

Silver can be absorbed through ingestion, topical administration, or inhalation. Generalized argyria results from deposition of silver in the skin, nails, mucous membranes, and internal organs and is characterized by a diffuse bluish-gray discoloration in sun-exposed areas. We report two cases of generalized argyria in patients on maintenance hemodialysis (HD) therapy for more than 15 years. They presented with diffuse hyperpigmentation of the face that was mistaken to be related to uremia and bluish-gray discoloration of all nails believed to be cyanosis. Histopathologic examination of skin biopsy specimens showed characteristic findings of argyria, which was further confirmed by radiograph microanalysis. Their serum silver levels were also elevated. No definite silver source could be determined. However, their argyria might be related to their long-term HD therapy because (1) they had been on HD therapy for more than 15 years and the discoloration appeared several years afterward, and (2) the water used for HD was not well processed in the early 1980s in Taiwan. Argyria should be suspected in chronic HD patients presenting with a diffuse bluish-gray discoloration of the skin and nails and evaluated carefully by skin biopsy.

Original languageEnglish
Pages (from-to)1048-1051
Number of pages4
JournalAmerican Journal of Kidney Diseases
Volume37
Issue number5
Publication statusPublished - 2001
Externally publishedYes

Keywords

  • Argyria
  • Hemodialysis (HD)
  • Hyperpigmentation
  • Silver
  • Uremia

ASJC Scopus subject areas

  • Nephrology

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  • Cite this

    Sue, Y. M., Yu-Yun Lee, J., Wang, M. C., Lin, T. K., Sung, J. M., & Huang, J. J. (2001). Generalized argyria in two chronic hemodialysis patients. American Journal of Kidney Diseases, 37(5), 1048-1051.