Haemolytic anaemia secondary to arsenic poisoning: a case report

Cases Journal

Table 1 In-hospital laboratorial course

	Day 1	Day 1*	Day 2	Day 3	Day 5	Day 6	Day 8	Day 10	Day 18
Hb, g/dL	13.8	11.5	8.0	9.4	8.7	7.9	9.3	9.9	10
WBC × 10⁹/L	18.01	18.44	20.85	10.56	8.71	8.64	12.39	11.82	12.74
PLT × 10⁹/L	209	167	141	69	89	89	124	250	299
CRP, mg/L	8.5	25.4	108.7	52	40.9	28.8	85.5	104	87.9
AST, U/L		112	121			207	57	34	35
ALT, U/L		33	36			193	156	91	31
γGT, U/L		18	19						27
ALP, U/L		71	62						43
TB, mg/dL		2.06	5.82	6.16		0.94	1.02	0.66	0.63
DB, mg/dL		0.43	0.51	0.48		0.23	0.72	0.15	0.14
LDH, U/L			4115	1430		997	659	549	289
Urea, mg/dL	80	135	188	182	144	112	70	65	59
Cr, mg/dL	1.55	2.56	3.59	4.96	4.43	4.34	3.45	3.86	2.79

Exposure to a gas mixture containing arsenic and copper occurred nearly 32 hours before initial medical evaluation. One session of plasmapheresis was performed at in-hospital day 2. Penicillamine was administrated from day 4 to 7, followed by dimercaprol during 10 days. Transfusion with 1 pack of red blood cells was performed at day 2. Haemolytic anaemia, renal dysfunction and hepatotoxicity recovered gradually after chelation therapy.
* Laboratorial results at approximately 12 hours of admission.