Acute Arsenic Poisoning: Clinical, Toxicological, Histopathological, and Forensic Features

Abstract

This report describes a suicide case by acute arsenic intoxication via intravenous injection. A 30-year-old woman injected arsenic As (V) (sodium arseniate disodique: Disodium Hydrogena Arsenik RP) in a successful suicide attempt. Three hours following administration, the woman developed severe digestive symptoms. She was admitted to a hospital and transferred to the intensive care unit within 12 h of the massive administration of arsenic. Despite therapeutic efforts, over the next 2 h she developed multiorgan failure and died. A postmortem examination was performed. Pulmonary edema and congestion of liver were apparent. As (V) and As (III) were determined by high performance liquid chromatography and inductively coupled plasma mass spectrometry after mineralization of samples by concentrated nitric acid. Toxicological analysis revealed high concentrations of arsenic in biological fluids as well as in organs. Histopathological examination showed a typical indication of myocarditis. These findings were in agreement with acute arsenic poisoning. The symptoms developed by this young woman (intoxication by intravenous administration) were comparable to oral intoxication. The clinical signs, survival time, and administration type are discussed in light of the literature on acute and chronic arsenic poisoning.

Acute toxicity of intratracheal arsenic trioxide instillation in rat lungs

“…The results showed that ATO exposure increased the lung water content ratio significantly, and the degree and duration of increase were exposure concentration‐dependent. Similarly, Tournel et al () found that acute ATO poisoning causes hemorrhagic pulmonary edema. Presumably, because As is in group 15 (Va) of the periodic table, during energy metabolism, As affects the formation of high‐energy phosphate bonds, thereby hindering cell energy metabolism.…”

Strain differences in arsenic-induced oxidative lesion via arsenic biomethylation between C57BL/6J and 129X1/SvJ mice

“…The liver is one of the primary targets for acute arsenic toxicity in vivo 4528. We examined plasma markers for liver injury, aspartate aminotransferase (AST) and alanine aminotransferase (ALT).…”

Properties of realgar bioleaching using an extremely acidophilic bacterium and its antitumor mechanism as an anticancer agent

“…There are many Chinese patent medicines, such as Niuhuang Jiedu Wan , Jufang Zhibao San , Fufang Qingdai Pian , Angong NiuHuang San , Wansheng Huafeng Dan , among others, containing realgar [90–92]. Because they contain a large dose of realgar, these medicines showed high toxicity and obvious gastrointestinal tract irritation in clinic [93]. Replacement of realgar with RBS in prescriptions will reduce the application of realgar, leading to better control of the concentration of.…”