II. Pathophysiology

  1. Ingestion of Arsenic (found in Insect poisons)
  2. Arsenic blocks cellular respiration and Gluconeogenesis at multiple sites

III. Symptoms

  1. Gastrointestinal Symptoms (within minutes to hours of ingestion)
    1. Nausea or Vomiting
    2. Abdominal Pain
    3. Diarrhea
  2. Cardiopulmonary symptoms and signs
    1. Cardiovascular collapse
    2. Acute Respiratory Distress Syndrome (ARDS)
    3. Dysrhythmia
    4. Paradoxically low Systemic Vascular Resistance (vasoplegia)
    5. Systemic Inflammatory Response Syndrome (SIRS)
  3. Neurologic Symptoms
    1. Headache
    2. Vertigo
    3. Fatigue
    4. Paresthesia
    5. Paralysis
    6. Encephalopathy with Delirium

IV. Signs: Chronic Poisoning

  1. Mottled brown skin
  2. Hyperkeratosis of palms and soles
  3. Cutis edema
  4. Transverse striate Leukonychia
  5. Perforation of nasal septum
  6. Eyelid Edema
  7. Coryza
  8. Limb paralysis
  9. Reduced Deep Tendon Reflexes
  10. Carcinogenic with chronic exposure

V. Labs

VI. References

  1. Kinker and Glauser (2021) Crit Dec Emerg Med 35(9): 19-27

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Related Studies

Ontology: Arsenic (C0003818)

Definition (CHV) A poisonous chemical used to kill weeds and pests
Definition (CHV) A poisonous chemical used to kill weeds and pests
Definition (CHV) A poisonous chemical used to kill weeds and pests
Definition (MEDLINEPLUS)

Arsenic is a natural element found in soil and minerals. Arsenic compounds are used to preserve wood, as pesticides, and in some industries. Arsenic can get into air, water, and the ground from wind-blown dust. It may also get into water from runoff.

You may be exposed to arsenic by

  • Taking in small amounts in food, water or air
  • Breathing sawdust or burning smoke from arsenic-treated wood
  • Living in an area with high levels of arsenic in rock
  • Working in a job where arsenic is made or used

Exposure to arsenic can cause many health problems. Being exposed to low levels for a long time can change the color of your skin. It can cause corns and small warts. Exposure to high levels of arsenic can cause death.

Agency for Toxic Substances Disease Registry

Definition (MSHCZE) Arsenicum, As (Z=33, Ar=74,9216). Prvek V.A skup. period. soustavy. Má více modifikací. Nejč. jako stříbřitě šedý kov, další modif. je žlutý a černý a. Slouč. velmi jedovaté, zejm. oxid arsenitý (arsenik čili otrušík, zvaný též jed Borgiů) a plynný arsenovodík (páchne po česneku). V soudním lékař. slouží k důkazu a. Marshova zkouška. Slouč. působí toxicky na kardiovask. systém, GIT, CNS, ledviny, játra, kůži. Má též karcinogenní a teratogenní úč. Dříve se slouč. a. užívalo k léčbě syfilis (Salvarsan). Slouč. a. byly známy již ve starověku, čistý připravil r. 1250 Němec Albertus Magnus. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ )
Definition (NCI) An element with atomic symbol As, atomic number 33, and atomic weight 74.92.
Definition (NCI_NCI-GLOSS) A poisonous chemical used to kill weeds and pests. Also used in cancer therapy.
Definition (MSH) A shiny gray element with atomic symbol As, atomic number 33, and atomic weight 75. It occurs throughout the universe, mostly in the form of metallic arsenides. Most forms are toxic. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985), arsenic and certain arsenic compounds have been listed as known carcinogens. (From Merck Index, 11th ed)
Definition (CSP) widely distributed element with atomic symbol As, atomic number 33, and atomic weight 75; occurs mostly in the form of metallic arsenides; most forms are toxic and carcinogenic.
Concepts Hazardous or Poisonous Substance (T131) , Element, Ion, or Isotope (T196)
MSH D001151
SnomedCT 413576005, 47809000
LNC LP16802-8, MTHU004556
English Arsenic, As, Arsenic [Chemical/Ingredient], arsenic (As), arsenics, ARSENIC, As element, arsenic, As - Arsenic, Arsenic (substance), Arsenic, NOS, Arsenic product (product), Arsenic product
Swedish Arsenik
Czech arsen, arzén
Finnish Arseeni
Croatian ARSEN
Latvian Arsēns
Polish Arsen
Norwegian Arsen
Portuguese Arsênio, Arsênico
Spanish arsénico (sustancia), arsénico, producto con arsénico (producto), producto con arsénico, Arsénico
French Arsenic
German Arsen
Italian Arsenico

Ontology: Arsenic Poisoning (C0311375)

Definition (MSH) Disorders associated with acute or chronic exposure to compounds containing ARSENIC (ARSENICALS) which may be fatal. Acute oral ingestion is associated with gastrointestinal symptoms and an encephalopathy which may manifest as SEIZURES, mental status changes, and COMA. Chronic exposure is associated with mucosal irritation, desquamating rash, myalgias, peripheral neuropathy, and white transverse (Mees) lines in the fingernails. (Adams et al., Principles of Neurology, 6th ed, p1212)
Concepts Injury or Poisoning (T037)
MSH D020261
ICD9 985.1
ICD10 T57.0 , T57.0X, T57.0X1
SnomedCT 81844008, 418685002
English Toxic effect of arsenic and its compounds, Arsenic and its compounds, As or As comp caus toxic effct, POIS ARSENIC NERVOUS SYSTEM, NERVOUS SYSTEM POIS ARSENIC, NEUROTOX SYNDROME ARSENICAL, ARSENIC POIS NERVOUS SYSTEM, ARSENIC POIS, Toxic effect of arsenic, poisoning by arsenic (diagnosis), poisoning by arsenic, Arsenic Poisoning, Nervous System, Nervous System Poisoning, Arsenic, Poisoning, Arsenic, Nervous System, Arsenic Poisoning, Poisoning, Arsenic, Arsenic Poisonings, Poisonings, Arsenic, Arsenical Neurotoxicity Syndrome, Arsenical Neurotoxicity Syndromes, Neurotoxicity Syndrome, Arsenical, Neurotoxicity Syndromes, Arsenical, Syndrome, Arsenical Neurotoxicity, Syndromes, Arsenical Neurotoxicity, Toxic effect arsenic, Arsenic Poisoning [Disease/Finding], arsenic poison, poison arsenic, arsenic poisoning, poisonings arsenic, Toxic effect of arsenic and its compounds NOS, Arsenic intoxication, Arsenic poisoning, Arsenical toxicity, Arsenic or arsenic compound causing toxic effect, Arsenic causing toxic effect, Toxic effect of arsenic AND/OR its compounds (disorder), Toxic effect of arsenic AND/OR its compounds, Toxic effect of arsenic and its compounds, NOS, Poisoning by arsenic or its compounds of undetermined intent (disorder), Poisoning by arsenic or its compounds of undetermined intent
Spanish intoxicación por arsénico o sus compuestos con intención no determinada (trastorno), intoxicación por arsénico o sus compuestos con intención no determinada, Efecto tóxico del arsénico y de sus compuestos, Efecto tóxico por arsénico, Envenenamiento por Arsénico, efecto tóxico del arsénico Y/O sus derivados (trastorno), efecto tóxico del arsénico Y/O sus derivados, efecto tóxico del arsénico y sus derivados, intoxicación por arsénico, toxicidad arsenical, Intoxicación por Arsénico
Dutch toxisch gevolg van arsenicum en zijn verbindingen, toxisch effect van arsenicum, Arseen en arseenverbindingen, Arsenicumvergiftiging, Vergiftiging, arsenicum-
French Effet toxique de l'arsenic et ses composés, Effet toxique de l'arsénic, Arsénicisme, Intoxication par l'arsenic, Intoxication arsenicale, Intoxication à l'arsenic
German toxischer Effekt von Arsen und seinen Verbindungen, toxischer Effekt von Arsen, Toxische Wirkung: Arsen und dessen Verbindungen, Arsenvergiftung
Portuguese Efeito tóxico de arsénio e seus compostos, Efeito tóxico por arsénico, Intoxicação por Arsênico
Swedish Arsenikförgiftning
Italian Effetti tossici dell'arsenico e suoi composti, Effetto tossico dell'arsenico, Avvelenamento da arsenico sul sistema nervoso, Sindrome neurotossica da arsenico, Avvelenamento da arsenico
Czech arsen - otrava, Toxický účinek arzenu a jeho sloučenin, Toxický účinek arzénu
Japanese ヒソノチュウドクサヨウ, 砒素の中毒作用, ヒ素中毒, 中毒-ヒ素, 慢性ヒ素中毒, 慢性砒素中毒, 砒素中毒, 砒素剤中毒, ヒ素剤中毒, 中毒-砒素
Finnish Arseenimyrkytys
Korean 비소 및 그 화합물의 중독작용
Polish Zatrucie arsenem
Hungarian Arzén toxikus hatása, Arzén és vegyületeinek toxikus hatása
Norwegian Arsenforgiftning i nervesystemet, Arsenframkalte neurotoksiske skader, Arsenframkalte toksiske nerveskader, Forgiftning, arsen, Forgiftning i nervesystemet, arsen, Arsenforgiftning