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Research Article

Survival After a Lethal Dose of Arsenic Trioxide

, , , , , , & show all
Pages 889-895 | Received 06 Aug 2003, Accepted 09 Jun 2004, Published online: 01 Oct 2004
 

Abstract

A case of a 27‐year‐old woman who ingested 9000 mg arsenic trioxide (As2O3) is reported. Classical symptoms of an acute arsenicum (As) poisoning such as gastrointestinal cramps, vomiting, diarrhea, ECG changes and disturbed liver function tests were observed. The absorption of the ingested As was minimalized by a continuous gastric irrigation with highly concentrated NaHCO3 andintestinal cleansing with NaHCO3 and polyethyleneglycol was performed. Forced diuresis, BAL (2,3‐dimercaptopropanol) and DMSA (meso‐2,3‐dimercaptosuccinic acid) were started and therapy to enhance the formation of methylated As derivatives, which are potentially less toxic and which can be excreted more easily, was then administered. The patient survived this massive dose of ingested inorganic As with only polyneuropathy one year later.

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