A patient ingests ceramic glaze in an attempt to harm and presents to the Emergency Department approximately 2 hours later with nausea, vomiting, diarrhea and weakness. What laboratory test will help confirm the diagnosis?
Serum potassium. Barium carbonate, hydroxide and chloride are used in the production of ceramics. Barium toxicity typically occurs within 2 hours after ingestion. Barium competitively antagonizes the inward rectifier potassium channels and increases sodium/potassium ATPase activity resulting in an increase in intracellular potassium and subsequent hypokalemia.
Jamshidi N et al. Life-threatening barium carbonate poisoning managed with intravenous potassium, continuous veno-venous hemodialysis and endoscopic removal of retained ceramic glazes. Clin Tox Published online 4 May 2022. https://doi.org/10.1080/15563650.2022.2068424