| [ Summary ] |
A 28-year-old man was transferred to our hospital 24 hours after ingesting about five times the lethal dosage of sodium arsenite for the purpose of suicide. Nausea, abdominal pain, and dizziness had developed when the patient was admitted to our hospital, and a strong garlic smell was detected. He was found to have anuresis without a response to diuretics, decreased blood pressure with tachycardia, and was thought to have peripheral circulatory collapse. A decrease in sedation, hand tremor, stiffness in the neck, paleness the hands and feet, and a decrease in sensorium levels appeared during the clinical course. A horizontal white line under the fingernails, known as Adrich-Mee's line, appeared on the fourth day. Exanthesis, and desquamation were observed. In addition, immunological studies showed a decrease in immunoglobulin values, and a degree of disorder in the myelocyte system was found by bone marrow aspiration. By using sodium thiosulfate, BAL, and hemodialysis, the arsenic concentration in the blood decreased from 21.4micro-g/dl to 2.8micro-g/dl. The decrease in arsenic concentration in the urine was delayed, but consequently fell below the standard value also. The symptoms gradually improved, and the patient was discharged after fifty-three days. |