Mysterious Case: Hong Kong Man Turns Grey from Rare Silver Poisoning

An 84-year-old man in Hong Kong puzzled doctors when he was admitted to the hospital with complications related to urinary flow obstruction. His case became even more intriguing due to an unusual grey discoloration of his skin, eyes, and nails—a change that had gradually developed over five years. Despite extensive medical evaluations, the cause remained unclear until blood tests revealed extremely high levels of silver in his body.

The man was diagnosed with argyria, a rare condition caused by the accumulation of silver particles in bodily tissues. This buildup typically results in a bluish-grey discoloration, especially in areas exposed to sunlight. Argyria is generally linked to prolonged exposure to silver through occupational contact, medications, dietary supplements, or topical products containing the metal. However, the patient’s only medication was finasteride, a drug commonly prescribed to treat benign prostate enlargement, which does not contain silver. Moreover, the man had no known occupational or environmental exposure to the metal, adding to the mystery.

Tests confirmed that the silver concentration in his blood was 423 nmol/L—40 times the normal level of less than 10 nmol/L. Silver ions tend to accumulate in various tissues, including the skin, heart, liver, lungs, and even the brain. When exposed to ultraviolet light, these ions undergo a photochemical reaction, resulting in the characteristic grey or blue tone associated with argyria. Interestingly, this process can take years to manifest noticeable discoloration, making it difficult to pinpoint the source of exposure.

Historically, argyria was more common among silver miners and artisans who regularly handled the metal. Before the advent of antibiotics, silver was also used for its antimicrobial properties in treating wounds. Today, the metal can still be found in some medications and dietary supplements marketed for detoxification or immune support, despite warnings from health authorities like the U.S. Food and Drug Administration (FDA). The FDA has declared silver unsafe and ineffective for treating any medical condition.

While argyria is primarily a cosmetic condition and does not usually pose significant health risks, extremely high levels of silver accumulation can slightly impair the body’s ability to absorb certain medications, such as antibiotics or thyroxine. Unfortunately, there is currently no effective treatment to reverse argyria or remove silver deposits from the body. Chelation therapy, often used to eliminate other heavy metals, has proven ineffective in cases of silver buildup. Skin laser treatments may offer some reduction in discoloration, but the results are inconsistent.

The patient’s case remains unresolved, as doctors were unable to identify how he had been exposed to such high levels of silver. Despite this, his overall health appeared unaffected, apart from the cosmetic changes. This case, published in The New England Journal of Medicine, highlights the challenges of diagnosing and understanding rare medical conditions like argyria and serves as a reminder of the potential risks associated with unregulated silver use.

References:

1. New England Journal of Medicine. "Case Records of the Massachusetts General Hospital: A 55-Year-Old Woman With Sudden Vision Loss." Accessed January 2025. https://www.nejm.org/doi/full/10.1056/NEJMicm2410226.

2. ScienceAlert. "Strange Case of Man Whose Skin Turned Gray Remains a Mystery." Accessed January 2025. https://www.sciencealert.com/strange-case-of-man-whose-skin-turned-gray-remains-a-mystery.

(Input from various sources)

(Rehash/Sai Sindhuja K/MSM)