Chronic arsenic poisoning following ayurvedic medication.
BACKGROUND
Ayurveda, Indian traditional system of medicine, is practiced commonly in South East Asia and in many parts of the world. Many ayurvedic drugs contain heavy metals and may lead to metal toxicity. Of these, chronic lead poisoning is the most common. Chronic arsenic poisoning following the use of ayurvedic medication, though reported, is rare.


METHODS
We describe three patients who presented with features of chronic arsenic poisoning following prolonged ayurvedic medication use. The diagnosis of chronic arsenic poisoning was confirmed by high arsenic levels in the blood, urine, hair, and nails in all the three patients and in ayurvedic drug in two patients. The ayurvedic medication was discontinued and treatment with D-penicillamine started. At 6 months after treatment, blood arsenic levels returned to normal with clinical recovery in all of them.


CONCLUSIONS
Arsenic poisoning following ayurvedic medication is much less common than lead poisoning, though mineral ayurvedic medicines may lead to it. We used D-penicillamine as chelator and all of them recovered. Whether withdrawal of medication alone or D-penicillamine also played a role in recovery is unclear and needs to be assessed.
Department of Internal Medicine, Nehru Hospital, Postgraduate Institute of Medical Education and Research, 4th Floor, Block F, Room 16, Chandigarh, 160012, India.
Benzeeta
B
Pinto
Palvi
P
Goyal
S J S
SJ
Flora
K D
KD
Gill
Surjit
S
Singh
D000328:Adult; D020261:Arsenic Poisoning / Q000188:drug therapy / Q000209:etiology*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008515:Medicine, Ayurvedic; D010396:Penicillamine / Q000627:therapeutic use
D010396:Penicillamine