• Nathan A Friedman and F Lee Cantrell.
• Division of Medical Toxicology, Department of Emergency Medicine, UC San Diego Health, San Diego, CA, United States of America; San Diego Division, California Poison Control System, San Diego, CA, United States of America; VA San Diego Healthcare System, San Diego, CA, United States of America. Electronic address: nafriedman@health.ucsd.edu.
• Am J Emerg Med. 2022 Oct 1; 60: 229.e5229.e6229.e5-229.e6.

AbstractBromism is an unusual syndrome characterized by a variety of nervous system impairments such as ataxia, confusion, and delusions. Contemporaneous cases are rare as therapeutic use of bromide-containing medications has declined, but bromides can still be obtained as unregulated dietary supplements. Bromism from dietary supplements is not well-described. We present a case of a 23-year-old male who was taking numerous supplements and developed bromism, characterized by ataxia, confusion, and persistent agitation. His laboratory evaluation revealed a large negative anion gap and a serum bromide level of 1200 mg/L (ref: 0-12 mg/L). He was treated with maintenance intravenous normal saline to promote excretion of the bromide ion and slowly returned to baseline over ten days. Bromism is an unusual but well-described constellation of neurologic impairments that presents insidiously and may be easily missed. The emergency physician should be aware of the dangers of bromide-containing dietary supplements and should educate patients taking these supplements of their risks.Copyright © 2022 Elsevier Inc. All rights reserved.

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