Acute arsenic self-poisoning for suicidal purpose in a dentist: a case report

Arsenic is a classical poison that has been historically used since ancient times for homicidal purposes. More recently, episodes of deliberate or unintentional arsenic self-poisoning have been increasingly reported. We describe here a case of a 77-year old male patient with a history of major depre...

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Bibliographic Details
Published in:Human & experimental toxicology 2009-01, Vol.28 (1), p.63-65
Main Authors: Yilmaz, Y, Armagan, E, Olmez, OF, Esen, M, Alkis, N, Dolar, E
Format: Article
Language:English
Subjects:
Acute Disease
Adult and adolescent clinical studies
Aged
Arsenic Poisoning - pathology
Arsenic Poisoning - therapy
Arsenicals
Biological and medical sciences
Carcinogenesis, carcinogens and anticarcinogens
Charcoal - therapeutic use
Chelating Agents - therapeutic use
Chelation Therapy
Chemical agents
Chemical and industrial products toxicology. Toxic occupational diseases
Dimercaprol - therapeutic use
Gastric Lavage - methods
Humans
Intubation, Gastrointestinal - methods
Male
Medical sciences
Metals and various inorganic compounds
Oxides - poisoning
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Suicide
Suicide, Attempted
Toxicology
Treatment Outcome
Tumors
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Summary:Arsenic is a classical poison that has been historically used since ancient times for homicidal purposes. More recently, episodes of deliberate or unintentional arsenic self-poisoning have been increasingly reported. We describe here a case of a 77-year old male patient with a history of major depression, who attempted suicide by ingestion of 4 g of arsenic trioxide. The man, a dentist by profession, used arsenic preparations for pulp devitalization. The patient was admitted to our hospital 5 h after arsenic ingestion with nausea and vomiting. Plain radiograph of the abdomen showed radio-opaque material in the stomach and small intestine. Nasogastric lavage, activated charcoal, and chelators were used to remove arsenic. On day 3, endoscopy disclosed the presence of gastritis and superficial ulcers. The patient developed significant anemia (Hb: 8.7 g/dL on day 7) without significant signs of hemolysis. He gradually recovered from anemia within 5 months. The patient did not suffer any adverse outcome in spite of having ingesting 4 g of arsenic, approximately 20 times the lethal dose.
ISSN:0960-3271
1477-0903
DOI:10.1177/0960327108097432