Massive acute arsenic poisonings

Area of Science:

• Toxicology
• Forensic Pathology
• Analytical Chemistry

Background:

• Arsenic poisoning, while less frequent than in previous decades, remains a critical area of toxicological study.
• Acute arsenic(III) oxide poisoning presents unique challenges in forensic and pathological investigations.
• Understanding arsenic distribution in ante- and post-mortem samples is crucial for accurate diagnosis and legal proceedings.

Observation:

• Three cases of massive acute arsenic poisoning were analyzed, including two with criminalistic backgrounds involving misidentification of arsenic for amphetamine, and one suicide.
• Ante-mortem blood and urine arsenic levels ranged from 2.3 to 6.7 microg/ml.
• Post-mortem tissues exhibited high total arsenic concentrations, with the duodenum in one case containing 30.1% arsenic(III) oxide.

Findings:

• Consistently high arsenic concentrations were detected in blood and tissues across all three cases.
• The observed arsenic levels in fatal poisonings are exceptionally rare.
• Forensic analysis revealed misintentioned ingestion of arsenic(III) oxide in two cases.

Implications:

• These findings underscore the importance of considering arsenic poisoning in forensic toxicology, even with atypical presentations.
• High arsenic concentrations in biological samples serve as critical indicators in poisoning investigations.
• The study highlights the need for comprehensive toxicological screening to identify arsenic, particularly in cases with suspicious circumstances or unusual drug histories.