The toxidrome of goitre, polycythaemia, cardiomyopathy, and metabolic acidosis is diagnostic of:-

Clinical Features of cobalt toxicity: 1. The classic toxidrome of chronic cobalt poisoning is the tetrad of goitre, polycythaemia, cardiomyopathy, and metabolic acidosis. 2. Chronic exposure to cobalt in the form of inhalation results in hard metal lung disease, characterised by pulmonary fibrosis and an obstructive airway syndrome. It can induce or exacerbate asthma. 3. Regular consumption of beer to which cobalt chloride or sulfate has been added (to enhance foaming) over a period of time can result in cardiomyopathy, referred to as beer drinker's hea which carries a relatively high moality of nearly 50%. 4. Dermal contact can cause "cobalt itch" or "carboloy-itch" (an allergic erythematous papular eruption). Chronic exposure can cause nerve deafness and optic atrophy. 5. Ingestion of magnets can cause acute cobalt toxicity. 6. Cobalt exposure has also been linked to an increased risk of cancer.