Podcast 573: Arsenic Toxicity

Arsenic is a heavy metal that binds to multiple cellular enzymes and inhibits aerobic metabolism

It is primarily absorbed through the skin, respiratory and GI tract.

The classic symptoms of heavy metal exposure are GI irritation (watery diarrhea, vomiting and abdominal pain) with multisystem organ failure.

Neuropathy can present insidiously

Initial work up includes EKG, and basic lab work (expect a delayed rise in liver function tests).

Acute arsenic ingestions can sometimes show up on imaging as it is radioapaque

Diagnosis is usually made with the history and evidence of multisystem organ failure.

Treatment should be coordinated with your local Poison Control or toxicologist and involves predominantly supportive care along with chelating agents succimer (oral) or dimercaprol (intramuscular)