Chronic bromide intoxication is rare.

Here we report cases of bromide intoxication documented or not with increased bromide concentrations in biological samples, recorded by the French West Poison Control Center.

A query on the national toxicovigilance (SICAP) database covering from 2000 to 2022 has been performed. Bromide concentrations were determined in blood and urine samples using inductively coupled plasma-mass spectrometry (ICP-MS) after 1/40 fold dilution.

Eight cases have been identified. The sex ratio was 3 men/5 women, the median age was 52 years old. The origin of intoxication was identified and included a prescribed drug (bromogalactogluconate calcium) (n=7) and potassium bromide (n=1). A pseudo-hyperchloremia was observed in 6 patients. The typical clinical picture associated cognitive impairment, confusion, balance disorders, drowsiness, and in some cases skin rash. The plasma bromide concentrations at admission ranged from 90mg/L to more than 2120mg/L. After arrest of the exposition to the drug and saline hydration, all patients had a positive outcome, without sequelae after their discharge from the hospital.

Bromide intoxication remains rare but the occurrence of pseudo-hyperchloremia, negative ion gap and clinical signs such as neurological disorders should lead to investigate the assumption of this type of intoxication. Bromide, included in the composition of some over the counter medications, should be taken with precaution.