Anemia arsenic poisoning

Besides the odor, there may be no other immediate sign that a person is breathing arsine. Its main effect is to destroy red blood cells, causing anemia (destruction of red blood cells) and kidney damage (from red blood cell debris). Within hours after a serious exposure, the victim may develop dark red or brown urine, back pain or belly pain, weakness, or shortness of breath. The skin or eyes may become yellow or bronze in color. Although arsine is related to arsenic, it does not produce the usual signs of arsenic poisoning. 

Answer E. The profile of lead toxicity includes decreased heme synthesis, anemia, nephropathy, and peripheral neuropathy, the last leading to foot drop or wrist drop. Garlic breath and watery stools are associated with arsenic poisoning. Chronic gingivitis and loose teeth are features of mercury poisoning. 

L Vesicants. Arsenical poisons. Like sulfur and nitrogen mustards. BAL in oil IM for systemic chelation. BAL ointment for eyes and skin. Shock after severe exposure. Hemolytic anemia, hemo-concentration. 

Chronic arsenic poisoning Chronic arsenic intoxication is manifested by skin changes, hair loss, bone marrow depression and anemia, and chronic nausea and gastrointestinal disturbances. Dimercaprol therapy appears to be of value. Arsenic is a known human carcinogen. 

Kleinfeld (1980) reported a case of arsine poisoning in a 31-y-old man. The exposure to arsine occurred from a leaking canister thought to be empty. The exposure duration was estimated to be 1-2 min, but no actual or estimated arsine concentrations were available. The victim presented with hematuria. On hospital admission, no intact erythrocytes were present in the urine, hematocrit was 43%, and hemoglobin was 9.8 g/ dL. The hematocrit dropped to as low as 18%, the correction of which required one unit of packed cells. Based upon the exposure history and the subject s note of a "garlicky" odor, the diagnosis was arsine-induced hemolytic anemia. Urinary arsenic was 7.2 mg/L on admission and 0.1 mg/L 4 d later. The patient was subsequently discharged. 

In addition to erythrocytes, blood contains white blood cells, called leukocytes, of several types, and platelets, also called thrombocytes, which control blood clotting. Hematopoiesis (from the Greek, haimo, for blood, and poiein for to make ) is the process by which the elements of the blood are formed. The marrow of bone contains so-called stem cells which are immature predecessors of these three types of blood cells. Chemicals that are toxic to bone marrow can lead to anemia (decreased levels of erythrocytes), leukopenia (decreased numbers of leukocytes), or thrombocytopenia. Pancytopenia, a severe form of poisoning, refers to the reduction in circulatory levels of all three elements of the blood. One or more of these conditions can result from sufficiently intense exposure to chemicals such as benzene, arsenic, the explosive trinitrotoluene (TNT), gold, certain drugs, and ionizing radiation. Health consequences can range... 

Iron is widely used in over-the-counter vitamin preparations and is a leading cause of childhood poisoning deaths. As few as 10-12 prenatal multivitamins with iron may cause serious illness in a small child. Poisoning with other metals (lead, mercury, arsenic) is also important, especially in industry. See Chapter 33 Agents Used in Anemias Hematopoietic Growth Factors and Chapter 58 Heavy Metal Intoxication Chelators for detailed discussions of poisoning by iron and other metals. 

Chnical features like skin lesions and neuropathy are crude and imprecise indicators of the severity of poisoning. The early clinical symptoms of arsenic toxicity are headache, dizziness, insomnia, weakness, nightmare, numbness in the extremities, anemia, palpitations, and fatigue. White striae in the fingernails are also a useful clue in the diagnosis of... 

As is one of the few chemical elements which is universally associated with the word poison . This reputation is not undeserved, for over the centuries, many deaths can be attributed to the administration of arsenic trioxide as inheritance powder . The metalloid has a dual reputation, for its use in medicine in earlier times is equally well documented. As was widely prescribed to treat skin diseases, fevers, malarial disorders, syphilis, lumbago, epilepsy, anemia, ulcers, etc ... 

Bone marrow depression, anemia, leukopenia, and basophilic stippling are associated with chronic arsenic exposure. Arsine (AsHj) poisoning can produce widespread hemolysis. Cirrhosis, ascites, and destruction of renal tissues have been reported. Arsine exposure may also cause renal failure (Forth et al. 1996). 

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