Arsenic Poisoning is characterized by projectile vomiting (bloody), burning pain in the stomach, watery diarrhea, dehydration, convulsions, uremia, and skin eruption.
Arsenic occurs in four forms:
Metalic (As), Trivalent compounds (As2O3), Pentavalent compounds (As2O5) and Arsenic gas (AsH3).
Mechanism of Toxicity
Arsenic combines with the -SH group of enzymes of the body and inhibits them. Thus leaving them non-functional. It also inhibits the oxidative decarboxylation of pyruvate to acetyl CoA and binds to the SH group forming a chelate and therefore, resulting in accumulation of pyruvic acid in the blood. Accumulated pyruvic acid interferes with the normal enzymatic activities in the body and disturbing cell metabolisms.
Signs & Symptoms (Acute Case)
- Projectile vomiting (bloody)
- Burning pain in the stomach
- Watery diarrhea
- Skin eruption
Gastric lavage (Charcoal, ferric oxide), Administration of antidote, BAL (Dimercaprol), Sodium thiosulphate, Purgatives, Morphine, Dialysis, I/V fluids & glucose
Cholera, Food Poisoning can be the differential diagnosis.
ECG Abnormalities in Arsenic Poisoning
ST Segment & T wave abnormalities are very commonly seen in arsenic poisoning.
Delayed manifestations of arsenic poisoning include foot drop, wrist drop, abnormal gait, paraesthesia, alopecia and peripheral neuropathy.mia.
Dehydrated, jaundice, cyanosis & wrinkled skin are seen externally during postmortem appearance.
The stomach is red velvet-like, corrosive of mucous membranes, particles of arsenic in the stomach, small acute ulcerations and petechial hemorrhages.
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