title: [Subacute arsenic poisoning].
abstract: A cas is reported of a 23-year-old man who voluntarily took a massive dose of arsenic (at least 8 g). In spite of the ingested amount and the acute nature of the poisoning, the patient survived 8 days. Gastrointestinal, neurologic and cardiac features were predominant including nausea, vomiting, choleroid diarrhoea, encephalopathy, peripheral neuropathy, and finally a fatal toxic cardiomyopathy. Metabolic acidosis, moderate cytolysis and an anticoagulant effect were also observed. This unique characteristic was partly due to a circulating anticoagulant with prothrombinase activity, as well as direct antivitamin K activity. Postmortem examination revealed: a congestive oesophagitis; a necrosing gastritis involving all the stomach wall; diffuse hepatic steatosis; skin lesions with vascular congestion and dermoepidermal detachment; discrete subepicardial congestive lesions. Arsenic was found in all tissues.
authors.affiliation: Département d'Anesthésie-Réanimation, Hôpital Saint-Roch, Nice.
authors.forename: M
authors.initials: M
authors.lastname: Ghariani
authors.forename: M L
authors.initials: ML
authors.lastname: Adrien
authors.forename: M
authors.initials: M
authors.lastname: Raucoules
authors.forename: J
authors.initials: J
authors.lastname: Bayle
authors.forename: Y
authors.initials: Y
authors.lastname: Jacomet
authors.forename: D
authors.initials: D
authors.lastname: Grimaud
mesh_terms: D000208:Acute Disease; D000328:Adult; D001151:Arsenic / Q000032:analysis; D020261:Arsenic Poisoning; D001778:Blood Coagulation Disorders / Q000139:chemically induced*; D002311:Cardiomyopathy, Dilated / Q000139:chemically induced; D003221:Confusion / Q000139:chemically induced; D004066:Digestive System Diseases / Q000139:chemically induced*; D006801:Humans; D008297:Male; D011115:Polyneuropathies / Q000139:chemically induced
chemical_list: D001151:Arsenic
vernacular_title: Intoxication suraiguë à l'arsenic.