title: Unexplained dyspnea in a patient of chronic arsenicosis: A diagnostic challenge and learning curve for physicians.
abstract: Chronic arsenic exposure causes cutaneous effects like hyperkeratosis, peripheral vascular disease, hypertension, ischemic heart disease, non-cirrhotic portal hypertension, hepatomegaly, peripheral neuropathy, respiratory involvement, bad obstetrical outcome, hematological disturbances, and diabetes mellitus. Here we present a case of a 24-year-old lady, with chronic exposure to arsenic, presenting to us with progressive dyspnea. We found pulmonary arterial hypertension (PAH) as a cause of her dyspnea. PAH can occur in arsenicosis, secondary to arsenic-induced chronic obstructive pulmonary disease (COPD), lung fibrosis, and portal hypertension, which we excluded by appropriate investigations in our case. We also excluded a familial or heritable form of PAH. Thus, with the exclusion of all these secondary causes of PAH, as well as a hereditary cause, we came to a conclusion that this PAH might be due to chronic arsenic exposure. To the best of our knowledge, no case of PAH in chronic arsenicosis has been reported to date.
authors: Department of Pulmonary Medicine, Nil Ratan Sarkar Medical College, Kolkata, West Bengal, India.
authors: Amitabha
authors: A
authors: Sengupta
authors: Department of Pulmonary Medicine, Nil Ratan Sarkar Medical College, Kolkata, West Bengal, India.
authors: Arnab
authors: A
authors: Maji
authors: Department of Pulmonary Medicine, Nil Ratan Sarkar Medical College, Kolkata, West Bengal, India.
authors: Debraj
authors: D
authors: Jash
authors: Department of Pulmonary Medicine, Nil Ratan Sarkar Medical College, Kolkata, West Bengal, India.
authors: Malay
authors: M
authors: Maikap
keywords: Chronic arsenicosis; dyspnea; pulmonary arterial hypertension