Chronic Arsenic Poisoning Following Ayurvedic Medication

Pinto, Benzeeta; Goyal, Palvi; Flora, Sjs; Gill, Kiran Dip; Singh, Surjit

doi:10.1007/s13181-014-0389-0

Cited by 30 publications

(29 citation statements)

References 15 publications

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“…Aplastic anemia and pancytopenia are also seen in heavy metal poisoning like arsenic, mercury, copper and lead as reported by Sharma B et al 12 . Leather tanneries nearby and arsenic poising due to ayurvedic remedies (bhasma) could be a cause for pancytopenia as reported by Sharma P and Pinto et al 13,14 .Arsenic also causes megaloblastic changes with dyserythropoeitic anemia so a high index of suspicion along with clinical history, examination and arsenic levels will help differentiation of this cases 15 .…”

Section: Discussionmentioning

confidence: 81%

Clinicopathological Spectrum of Pancytopenia in Tertiary Care Centre in Northern India

Patiri¹,

Khatri²,

Sidam³

et al. 2018

RAPL

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Introduction: The term pancytopenia refers to a reduction in all three formed elements of blood-erythrocytes, leucocytes and platelets. It is not a disease entity, but rather a triad of findings that may result from a number of disease processes. The causes of pancytopenia vary depending on multiple factors. This prospective study was conducted to find out various causes of pancytopenia and their relative frequencies in a tertiary care hospital in northern India. Methods: In the present study, 60 cases were taken up for a period of 2 years at a tertiary care hospital in Northern India. The study was composed of a brief work up of history, general and systemic examination and complete hematological work up. All the data was compiled and a final diagnosis was made. Results: The age of the patients varied from 6 months to 70 years consisting of 34 males (57%) and 26 females (43%). Megaloblastic anemia was the most common cause (66.7%) followed by aplastic anemia (19%) and malignancies (6.7%). Infections and parasitic infestations accounted for the rest. Conclusion: In our study, more than 50% of the cases are due to megaloblastic anemia prevalent due to dietary deficiency & malnutrition. Also, infections and infestations (Tuberculosis, malaria, kalaazar and typhoid) should be kept in mind as a differential diagnosis of pancytopenia.

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Section: Discussionmentioning

confidence: 81%

Clinicopathological Spectrum of Pancytopenia in Tertiary Care Centre in Northern India

Patiri¹,

Khatri²,

Sidam³

et al. 2018

RAPL

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“…It also mobilizes As, but it is not generally a drug of choice (Hall 2002). In the clinical case of poisoning with As, which developed after the administration of contaminated Ayurvedic drugs, the state of patients was improved after the withdrawal of the medications and treatment with PCA (Pinto et al 2014). Although, in this case, the patient's condition was improved, the effectiveness of PCA for treating As poisoning is contradictory.…”

Section: Dmpsmentioning

confidence: 88%

Arsenic intoxication: general aspects and chelating agents

et al. 2020

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Arsenic (As) is widely used in the modern industry, especially in the production of pesticides, herbicides, wood preservatives, and semiconductors. The sources of As such as contaminated water, air, soil, but also food, can cause serious human diseases. The complex mechanism of As toxicity in the human body is associated with the generation of free radicals and the induction of oxidative damage in the cell. One effective strategy in reducing the toxic effects of As is the usage of chelating agents, which provide the formation of inert chelator-metal complexes with their further excretion from the body. This review discusses different aspects of the use of metal chelators, alone or in combination, in the treatment of As poisoning. Consideration is given to the therapeutic effect of thiol chelators such as meso-2,3-dimercaptosuccinic acid, sodium 2,3-dimercapto-1-propanesulfonate, 2,3-dimercaptopropanol, penicillamine, ethylenediaminetetraacetic acid, and other recent agents against As toxicity. The review also considers the possible role of flavonoids, trace elements, and herbal drugs as promising natural chelating and detoxifying agents.

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“…Chronic arsenic ingestion leads to its accumulation in several organs including the lungs and skin, for which chelation therapy is recommended based on a few individual cases and clinical expert opinion in order to reduce the arsenic burden from these organs and decrease the level of arsenic in blood by excreting it out through urine. 1,5,20,[30][31][32][33] As there are no proper treatment protocols for prescribing d-penicillamine in acute as well as chronic arsenic poisoning, our patient, who was found to have raised arsenic blood levels, was given d-penicillamine for two weeks without monitoring blood and urine arsenic levels during and after chelating therapy because of the social factors outlined earlier. Another advantage of using oral retinoids is that they can be used as a chemopreventive medication for arsenic-related cancers, by altering gene expression.…”

Section: Figure 6 -Mri Images Of the Right Wrist (T1wi Sagittal) Showmentioning

confidence: 99%

Case Report of Cutaneous Squamous Cell Carcinoma at the Wrist Joint and the Public Health Crisis of Arsenicosis

Sachan

Pathania²,

Mahdi

et al. 2021

Journal of Health and Pollution

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Context. Arsenicosis is caused by long term (6 months plus) ingestion of arsenic above a safe dose, characterized by skin lesions and possible involvement of internal organs. Arsenicosis is common in India and Bangladesh where naturally occurring high concentrations of arsenic in the earth's crust contaminate ground water, causing adverse health effects. Case Presentation. We report a case of a 55-year-old Indian male, resident of a known arsenic endemic region of Uttar Pradesh who suffered from characteristic pulmonary and cutaneous features of chronic arsenic toxicity which included radiological findings of interstitial lung disease, hyperkeratotic lesions over the palms and soles, rain drop like pigmentation over the trunk, and carcinomatous changes at the wrist joint. The patient was started on chelating agents (d-penicillamine) and oral retinoids (isotretinoin) followed by the surgical excision of the carcinoma. Discussion. Environmental contamination with arsenic is a well-known health hazard in South Asian countries. The main source is consumption of contaminated ground water for domestic purposes. Cutaneous lesions, internal organ involvement including interstitial lung disease and carcinomas as observed in our patient have been reported in the literature. Various mechanisms like epigenetic changes and arsenic-induced immune suppression have been proposed for the development of cutaneous carcinomas with prolonged exposure to arsenic. Relevance to Clinical Practice. Among the various causes of palmo-plantar hyperkeratosis, arsenicosis should be kept in mind when presenting in combination with pigmentary changes and carcinomatous growth from an arsenic-endemic region. Conclusions. People residing in arsenic-endemic regions should be made aware of arsenic-related health hazards. Rainwater harvesting and good nutrition are the simplest measures which could be adopted by the exposed population in affected areas. Several methods have also been employed by governmental and non-government organizations to separate arsenic from contaminated water to combat arsenic-related diseases and carcinomas. Competing Interests. The authors declare no competing financial interests.

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Chronic Arsenic Poisoning Following Ayurvedic Medication

Cited by 30 publications

References 15 publications

Clinicopathological Spectrum of Pancytopenia in Tertiary Care Centre in Northern India

Clinicopathological Spectrum of Pancytopenia in Tertiary Care Centre in Northern India

Arsenic intoxication: general aspects and chelating agents

Case Report of Cutaneous Squamous Cell Carcinoma at the Wrist Joint and the Public Health Crisis of Arsenicosis

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