Arsenic Poisoning in Childhood an Unusual Case Report with Special Notes on Therapy with Penicillamine

Abstract

An unusual case of As ingestion involving 5 children is reported, which involved the process of sublimation. As2O3 was inadvertently heated in a charcoal barbecue [an herbicide had been accidentally spilled over a barbecue grill and the underlying gravel; the grill was scrubbed and most of the gravel removed], and the chicken cooked thereon was contaminated. It is possible that the sublimation may have potentiated the toxicity of the usually mildly toxic, relatively insoluble As2O3. Penicillamine was used in the latter part of the therapy in 3 cases after initial dimercaprol, and the clinical effect of penicillamine was particularly dramatic in 1 case in which dimercaprol discontinuation was accompanied by recurrent symptoms. Remarks on the mode of action of penicillamine are made. More work needs to be done to establish the possible role of penicillamine in As poisoning.