[Acute poisoning caused by intravenous arsenic].
BACKGROUND
During acute sodium arsenite intoxication, absorption is usually oral and rarely respiratory. We report the first case of acute intoxication by intravenous administration, with pharmacokinetic modelling.


METHODS
A 38 year-old man had attempted suicide by injecting a solution of sodium arsenite. The first symptoms upon admission to an emergency unit were hypotension, electrocardiographical disorders with prolonged QT and aqueous diarrhoea. Dimercaprol therapy was immediately set-up but was stopped on 48 hours later because of acute renal failure. Eleven successive blood and urine samples were drawn. Hairs and nails were sampled at the 130th hour. Results of the confirmed the elevated arsenic concentrations in all the samples. The pharmacokinetic parameters were computed following a two-compartment model with intravenous administration and with elimination from the central compartment.


CONCLUSIONS
During this acute intravenous induced arsenic poisoning, the symptomatology was comparable to that following oral intoxication. The chelating treatment, although rapidly suspended, obviously contributed to survival. The eventual occurrence of other cases should permit the adaptation of therapeutic protocols to these types of intoxication.
Pélissier-Alicot
Anne-Laure
AL
Service de médecine légale, Faculté de médecine, Marseille. apelissier@netcourier.com
Salério
Géraldine
G
Marquet
Pierre
P
Panteix
Gilles
G
Léonetti
Georges
G
D000328:Adult; D001151:Arsenic / Q000008:administration & dosage / Q000032:analysis; D020261:Arsenic Poisoning / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D013406:Suicide, Attempted
D001151:Arsenic