Recovery from severe arsenic-induced peripheral neuropathy with 2,3-dimercapto-1-propanesulphonic acid.
A 33-year-old female with a 1.5-year history of multisystem illness was diagnosed with arsenic poisoning. Twenty-four-hour urine arsenic was 1030 microg/dL (normal 0-99) and root hair arsenic was 130 microg/g (normal 0-3). Despite treatment with succimer meso-2,3-dimercaptosuccinic acid, her neuropathy progressed to ventilator dependence and quadriplegia. Subsequent intravenous treatment with 2,3-dimercapto-1-propanesulfonic acid sodium salt was associated with arsenic diuresis, marked neuropathic improvement, and extubation. At 1-year follow-up, neuropathy was limited to mild distal lower extremity weakness and sensory loss. The use of 2,3-dimercapto-1-propanesulphonic acid in the treatment of severe arsenic neuropathy was associated with increased urinary elimination of arsenic and dramatic clinical recovery.
Wax
P M
PM
Department of Emergency Medicine, University of Rochester School of Medicine, New York 14642, USA. paul_wax@urmc.rochester.edu
Thornton
C A
CA
D000328:Adult; D001151:Arsenic / Q000652:urine; D020261:Arsenic Poisoning / Q000188:drug therapy*; D002614:Chelating Agents / Q000737:chemistry / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced* / Q000188:drug therapy*; D014494:Unithiol / Q000737:chemistry / Q000627:therapeutic use*
D002614:Chelating Agents; D014494:Unithiol; D001151:Arsenic