Arsenic Poisoning Part-4

Arsenic Poisoning Part-4

How is arsenic poisoning diagnosed?

The history of the patient is very important as exposures are most often from industrial accidents so other people (coworkers, rescue personnel) may be exposed and not realize they may have some risk also. People exposed to toxic levels of arsenic may have breath and urine that smells like garlic as a clue to their diagnosis. Most doctors that suspect arsenic (or other metal or metalloid poisonings) will request lab studies such as blood cell counts and serum electrolytes such as calcium and magnesium; if there is evidence of hemolysis (blood cell destruction), a type and screening for a potential blood transfusion is done.

 There are rapid urine "spot" tests available to diagnose elevated levels of arsenic, but they usually don't distinguish between organic and inorganic arsenic. The patient's blood and urine will be sent for analysis for arsenic; a result of > 50 micrograms/L is considered elevated, but acute toxic exposures may result in levels 5 to 100 times or more than those which are considered "elevated." A speciation test (determines levels of inorganic versus organic arsenic) is required in all cases in which total urine arsenic is elevated since inorganic arsenic is so toxic. Electrocardiograms (ECG, EKG) and nerve conduction tests are often done in any type of suspected arsenic exposure. Tests for other toxins or toxic overdoses (for example, Tylenol ingestion) may also be done.