• Anne-Laure Pélissier-Alicot, Géraldine Salério, Pierre Marquet, Gilles Panteix, and Georges Léonetti.
• Service de médecine légale, Faculté de médecine, Marseille. apelissier@netcourier.com
• Presse Med. 2003 Dec 13; 32 (39): 1849-51.

IntroductionDuring acute sodium arsenite intoxication, absorption is usually oral and rarely respiratory. We report the first case of acute intoxication by intravenous administration, with pharmacokinetic modelling.ObservationA 38 year-old man had attempted suicide by injecting a solution of sodium arsenite. The first symptoms upon admission to an emergency unit were hypotension, electrocardiographical disorders with prolonged QT and aqueous diarrhoea. Dimercaprol therapy was immediately set-up but was stopped on 48 hours later because of acute renal failure. Eleven successive blood and urine samples were drawn. Hairs and nails were sampled at the 130th hour. Results of the confirmed the elevated arsenic concentrations in all the samples. The pharmacokinetic parameters were computed following a two-compartment model with intravenous administration and with elimination from the central compartment.DiscussionDuring this acute intravenous induced arsenic poisoning, the symptomatology was comparable to that following oral intoxication. The chelating treatment, although rapidly suspended, obviously contributed to survival. The eventual occurrence of other cases should permit the adaptation of therapeutic protocols to these types of intoxication.

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