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Acute Arsenic Poisoning: A Case Report and Literature Review
Sachin Wali1, Shreyas Gutte1, Ravikant Nair2
1Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Abstract:
Acute arsenic poisoning, a life-threatening condition, results from exposure to inorganic arsenic compounds such as arsenic trioxide (As2O3). This case report describes a 27-year-old male who ingested 25 g of As2O3 and presented with severe gastrointestinal (GI) toxicity and acute kidney injury. Management involved airway protection, GI decontamination with activated charcoal, chelation therapy using D-penicillamine, and supportive care including N-acetylcysteine (NAC) and dialysis for renal failure. GI endoscopy revealed diffuse mucosal ulceration consistent with arsenic's corrosive effects. The patient recovered following three sessions of sustained low-efficiency dialysis and was discharged with improved renal function. This case highlights the critical role of prompt supportive management, chelation, and hemodialysis in arsenic poisoning. It also highlights novel use of NAC as an adjunctive therapy and the importance of monitoring multi-organ involvement for improved outcomes.
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