Effect of Aluminium Toxicity in Infants

Aluminium is the most abundant metal ion in the biosphere and we are continuously exposed to it in our everyday life through food, beverages, pharmaceutical products, etc. This book is a current and comprehensive review of the biochemistry, metabolism and toxicity of aluminium undertaken by an international group of authors, many of whom are outstanding authorities in their respective fields. In contrast with previous books on this topic, much of the subject matter is unique, in that it is primarily directed at aluminium nutrition and toxicity in infants and children. This book covers many aspects of aluminium toxicity in infants including for instance the embryo-fetal as well as the neurodevelopmental effects of this element, contamination of pharmaceutical products, and individual sensitivity through vaccines using aluminium as an adjuvant. This book will be especially useful to paediatricians, paediatric nephrologists & neurologists, nutritionists, toxicologists, biochemical toxicologists and postgraduate students. There is concern that infants with immature and developing tissues may be more vulnerable to the toxic effects of aluminium. However, exposure does not necessarily equate with tissue deposition and tissue deposition does not necessarily equate with symptoms as the critical tissue load that results in systemic disorder remains to be determined. Orally ingested pharmacological doses of aluminium in infants with renal failure have been clearly associated with symptomatic tissue deposition and should be avoided. Intravenous aluminium in neonates with normal renal function has been associated with deposition although whether this is symptomatic or not is more difficult to assess. The level of exposure which could be considered acceptable has yet to be determined. Oral pharmacological doses in infants with normal renal function has been associated with increased serum levels but as tissue levels have not been measured, judicious use of these agents is recommended together with careful monitoring. It is unlikely that non-pharmacological doses in infants with normal renal function are hazardous. According to their parents, some children with aluminium contact allergy and vaccination granulomas may react to aluminium-containing foods by developing dermatitis, granuloma itch and subjective symptoms. To determine whether oral intake of aluminium-containing pancakes can cause adverse events and/or systemic contact dermatitis (SCD) in children with vaccination granulomas and aluminium contact allergy.  A total of 15 children aged 3-9 years with vaccination granulomas and positive patch-test results to aluminium chloride hexahydrate. Completed a 3-week blinded randomized controlled crossover oral aluminium/placebo provocation study with pancakes. Granuloma itch and other subjective symptoms were evaluated daily on a visual analogue scale (VAS). Dermatitis was evaluated by the primary investigator, and sleep patterns were tracked with an electronic device. Aluminium bioavailability was assessed by measuring aluminium excretion in the urine. The children served as their own controls with the placebo provocations. All 15 children completed the study. There were no differences in sleep patterns and no significant correlation between urinary aluminium excretion and symptom severity. Three children developed a symmetrical rash on the face or buttocks on day 4 of the aluminium provocations, but not during placebo provocations. No difference was found between oral aluminium intake and the occurrence of subjective symptoms and granuloma itch, but on a case-basis oral aluminium may be associated with the development of systemic contact dermatitis.

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Journal of Heavy Metal Toxicity and Diseases