Chronic Arsenic Toxicity

Mazumder, D. N. Guha; De, Binay K; Santra, Amal; Dasgupta, Jayanta; Ghosh, Nilima; Roy, Bijon; Uc, Ghoshal; Saha, Jyoti Prasad; Chatterjee, Amit; Dutta, Souvik; Haque, Reina; Smith, Allan H.; Chakraborty, Debjani; Angle, Carol R.; Centeno, José A.

doi:10.1016/b978-008043648-7/50037-6

Cited by 27 publications

(11 citation statements)

References 14 publications

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“…[11] If the source of arsenic is not removed, additional signs and symptoms develop, with specific toxicities depending upon the level and duration of exposure. [12] Dermatological features are generally one of the initial signs of arsenicosis, and often presents as keratosis of the palms and soles, along with a characteristic "raindrop" pattern of hyperpigmentation on the trunk and extremities. [11,12] Arsenicosis has also been associated with the development of peripheral neuropathy, bone marrow suppression, hypertension, cardiovascular disease, and various malignancies, among others.…”

Section: Discussionmentioning

confidence: 99%

“…[12] Dermatological features are generally one of the initial signs of arsenicosis, and often presents as keratosis of the palms and soles, along with a characteristic "raindrop" pattern of hyperpigmentation on the trunk and extremities. [11,12] Arsenicosis has also been associated with the development of peripheral neuropathy, bone marrow suppression, hypertension, cardiovascular disease, and various malignancies, among others. [13][14][15][16][17] In addition to the aforementioned toxicities, arsenicosis is a well-documented secondary cause of DM.…”

Section: Discussionmentioning

confidence: 99%

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A case of secondary diabetes mellitus associated with chronic arsenic toxicity

Moorman

Boros

Ciltea³

et al. 2016

CRIM

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Chronic arsenic exposure leads to systemic illness involving multiple organ systems, and has been associated with the development of diabetes mellitus (DM). While the majority of the literature surrounding arsenic-induced DM is from areas where the arsenic content of drinking water is high, population-based studies in North America have shown a similar association. Here, we present a case of newly-diagnosed DM thought to be secondary to chronic arsenic exposure. The patient was a previously healthy 54-year-old female who presented with progressive fatigue, weight loss and anorexia, and eventually developed colitis, cachexia, skin eruptions, and alopecia. She was also diagnosed with DM, and treatment was complicated by episodes of severe hyper-and hypoglycemia. She was evaluated for autoimmune, rheumatologic, oncologic, and infectious etiologies of her symptoms, all of which were negative. Also negative was an extensive workup for secondary causes of DM. During her final hospitalization, she underwent a workup for heavy metal toxicity, which revealed elevated serum (11 mcg/L, reference range < 5 mcg/L) and urine (233.5 mcg/gram creatinine, reference range < 50 mcg/gram creatinine) arsenic levels. A diagnosis of arsenic toxicity was made, and the patient underwent chelation therapy with British anti-Lewisite (BAL). This is an interesting case of DM that was thought to be secondary to chronic arsenic exposure. While BAL was effective at lowering arsenic levels, we were unable to observe clinical improvement due to the patient's death shortly after completion of therapy. In cases where other secondary causes of DM are ruled out, it may be prudent to evaluate for heavy metal toxicity to allow for early diagnosis and initiation of treatment. Further studies are needed to determine the efficacy of different treatment strategies for arsenic-induced DM, and whether resolution of arsenic toxicity will reverse the diabetogenic effects.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A case of secondary diabetes mellitus associated with chronic arsenic toxicity

Moorman

Boros

Ciltea³

et al. 2016

CRIM

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“…Arsenicosis results from prolonged exposure to arsenic at a dose of 5 to 90 mg/kg body weight per d (5) . The clinical features are characterized by hyper-and hypo-pigmentation, keratosis and various systemic manifestations like weakness, anaemia, chronic lung disease, peripheral neuropathy, liver fibrosis, gangrene of the limbs and cancers of the skin, lung and urinary bladder (6)(7)(8) . Studies on populations in Taiwan, India and Argentina exposed to arsenic through drinking water have suggested that malnutrition increases the risk of arsenic-induced diseases (9)(10)(11)(12)(13) .…”

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confidence: 99%

Nutritional deficiency and arsenical manifestations: a perspective study in an arsenic-endemic region of West Bengal, India

Deb

Biswas

Ghose

et al. 2012

Public Health Nutr.

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Objective: To assess whether nutritional deficiency increases susceptibility to arsenic-related health effects. Design: Assessment of nutrition was based on a 24 h recall method of all dietary constituents. Setting: Epidemiological cross-sectional study was conducted in an arsenicendemic area of West Bengal with groundwater arsenic contamination. Subjects: The study was composed of two groups -Group 1 (cases, n 108) exhibiting skin lesions and Group 2 (exposed controls, n 100) not exhibiting skin lesions -age-and sex-matched and having similar arsenic exposure through drinking water and arsenic levels in urine and hair. Results: Both groups belonged to low socio-economic strata (Group 1 significantly poorer, P , 0?01) and had low BMI (prevalence of BMI , 18?5 kg/m 2 : in 38 % in Group 1 and 27 % in Group 2). Energy intake was below the Recommended Daily Allowance (set by the Indian Council of Medical Research) in males and females in both groups. Increased risk of arsenical skin lesions was found for those in the lowest quintile of protein intake (v. highest quintile: OR 5 4?60, 95 % CI 1?36, 15?50 in males; OR 5 5?62, 95 % CI 1?19, 34?57 in females). Significantly lower intakes of energy, protein, thiamin, niacin, Mg, Zn and choline were observed in both males and females of Group 1 compared with Group 2. Significantly lower intakes of carbohydrate, riboflavin, niacin and Cu were also observed in female cases with skin lesions compared with non-cases. Conclusions: Deficiencies of Zn, Mg and Cu, in addition to protein, B vitamins and choline, are found to be associated with arsenical skin lesions in West Bengal. Keywords Arsenic manifestations Energy intake Micronutrients ProteinArsenic exposure through drinking water is a major health problem affecting many countries such as Bangladesh,

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“…Inorganic arsenic trioxide is a component of geologic formations and can be washed out into the ground water (M. T. Islam et al, 2011). Chronic arsenic toxicity due to drinking of arsenic contaminated ground water is a major environmental health hazard throughout the world (Mazumder, 2008). WHO described the condition as "the largest mass poisoning of a population in history" (WHO, 2004).…”

Section: Introductionmentioning

confidence: 99%

Environmental health hazard of arsenic on epididymis and ductus deferens in male Black Bengal Goats

Wares

Awal

Nasrin

et al. 2014

J Bangladesh Agric Univ

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Histomorphological changes of epididymis and ductus deferens in male Black Bengal goat due to arsenic were studied. A total of 12 male Black Bengal goats, in which 6 were collected from arsenic affected areas of Mymensingh district and another 6 were collected from hill tracts of Chittagong which were arsenic free.The goats were sacrificed by piercing carotid artery and the samples (Epididymis and Ductus deferens) were collected immediately. Samples were prepared and stained with haematoxylin and eosin stain technique to study the histology under light microscope. In the morphological study, measurement of length, width, breadth and weight of epididymis and ductus deferens were observed. The gross study revealed that there were slight variations in the gross morphology of epididymis and ductus deferens of arsenic affected Black Bengal goat, but this variation was statistically insignificant. In the histological study, arsenic affected goat showing increased thickness of epididymal covering (P<0.05) and trabeculae compared to control group of epididymis. The diameter of ductule efferentes of arsenic affected goat was narrower (P<0.01), width between intertubular space of ductuli efferentes was wider (P<0.01), lumen of ductules contain smaller in amount of spermatozoa compared to control group. The wall of the ductus deferens was thicker in arsenic affected goats than the control group (P<0.01). It may be concluded that environmental health hazard of arsenic might have adverse effects on the male reproductive organs.

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Chronic Arsenic Toxicity

Cited by 27 publications

References 14 publications

A case of secondary diabetes mellitus associated with chronic arsenic toxicity

A case of secondary diabetes mellitus associated with chronic arsenic toxicity

Nutritional deficiency and arsenical manifestations: a perspective study in an arsenic-endemic region of West Bengal, India

Environmental health hazard of arsenic on epididymis and ductus deferens in male Black Bengal Goats

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