5.2 Argyria

Definition: Argyria is a condition caused by improper exposure to chemical forms of the element silver. Argyria may be found as generalized argyria or local argyria (argyrosis). The kidney is usually involved in aryria.

Argyria(from Greek: ἄργυρος argyros silver) is a condition caused by improper exposure to chemical forms of the element silver, silver dust, or silver compounds (colloidal silver, silver salts, silver containing drugs). The most dramatic symptom of argyria is that the skin becomes blue or bluish-grey coloured. Argyria may be found as generalized argyria or local argyria (argyrosis). The disease was termed “argyria“ by the German physician Johann Abraham Albers in 1816.

The disease was a problem in the 19 ^th and early 20 ^th century.  Due to industrial  and medical exposure to silver (colloidal  silver, a liquid suspension of microscopic  silver particles) to treat a variety of diseases. "Colloidal silver" and other preparations are still  marketed,  or  even homemade, as alternative  medicine, without  any proven effectiveness but with the risk of side effects.

Chronic intake of silver products can result in an accumulation of metallic silver or silver sulfide particles in the skin, eye, mucous membranes and parenchymal organs e.g. kidney. The Agency for Toxic Substances and Disease Registry (ATSDR) considers silver deposits in tissue to be relatively harmless, without risk of serious health impairment. Even massive exposure of rats to Ag NO₃ does not result in structural damage to the kidney in rats.

Aryrosis of the kidney

The macroscopic picture of the kidney is not mentioned in older textbooks. A greyish discoloration must, however, be expected since in a formalin fixed renal biopsy black dots are visible in the cortex with the naked eye, whereas the medulla is unaffected.

In unstained 2-3 um thick sections, the glomerular basement membranes are clearly outlined by black granules. The obsolescent glomeruli are even more strongly stained, due to collapse of the capillary loops.

Electron microscopy confirms the “decoration” of the glomerular basement membranes with silver grains, confirmed by energy filtered transmission electron microscopy (EFTEM), with preferred localization to the endothelial aspect of the vessel lumen.

Interestingly, no silver signal was detected in any lysosomal compartment of the podocytes, endothelial or mesangial cells, nor any other compartment of the kidney. In the older literature, however, based on autopsy data, silver deposits were not only described in the basement membranes of the glomerular loops, but also in the basement membranes of the peritubular capillaries and around the elastic lamellae of arteries.