International Clinical and Medical Case Reports Journal (ISSN: 2832-5788) | Volume 3, Issue 12 | Case Series | Open Access
Raghavi Abhilesh Bembey*
Meena Dilip1, Raghavi Abhilesh Bembey2*, Mitakshara Chawla3, Ajay Chauhan4
1PG Resident, Department of Medicine, ABVIMS & Dr. RML Hospital, New Delhi
2Senior Resident , Department of Medicine, ABVIMS & Dr. RML Hospital, New Delhi
3PG Resident,Department of Medicine, ABVIMS & Dr. RML Hospital, New Delhi
4Associate Professor and Consultant, Department of Medicine, ABVIMS & Dr. RML Hospital, New Delhi
*Correspondence to: Raghavi Abhilesh Bembey
Fulltext PDFArsenic is a metalloid element and is notorious for causing toxicity in humans. Lower-dose chronic arsenic exposure can result in subacute toxicity that can include skin changes and skin cancer, peripheral sensorimotor neuropathy, diabetes mellitus, cardiovascular effects, peripheral vascular disease, hepatotoxicity, and other conditions. Sensory-motor polyneuropathy encompasses a spectrum of peripheral nervous system disorders with diverse clinical manifestations and etiologies, a rare one being arsenic toxicity. We present a case series of three members of a family who developed sensory-motor polyneuropathy at the same time. This case series highlights the unique presentations, diagnostic challenges, and rehabilitation considerations for this family caused by arsenic.
We present this case series of subacute poisoning of arsenic in the three members of a family of 10 members, all presenting with peripheral neuropathies, typical Mee’s lines, and dermatological changes. This was a diagnostic challenge as it mimicked many common diseases like GBS, CIDP, etc. with a positive history of preceding loose stools and fever with no evident source of exposure. In the first case, a sensorimotor polyneuropathy with a demyelinating axonal variant was observed. This case presented with sensory deficits accompanied by predominant motor symptoms, distal more than proximal. The second case exhibited a sensory-motor variant, primarily manifesting with sensory symptoms distal more than proximal. In the third case, motor symptoms were prominent at presentation, along with evident demyelinating changes. Medical treatment was sought later due to various reasons and all patients had an incomplete recovery at discharge, but almost full recovery on follow-up. All the common sources of arsenic were explored and found to be increased in drinking water that was taken out through a hand pump. During the summer months, the only 3 members in the house were forced to use the old deep tubewell in their house water for all their daily needs including cooking and drinking due to disruption in the municipality water supply to their house. Levels of arsenic in drinking water were significantly above the WHO safe limit for arsenic. Apart from their presentations, rehabilitation/physiotherapy and a review of literature is discussed in detail.
Arsenicosis; Groundwater; Sensory-motor polyneuropathy; mee’s line; DMSA; Dimercaprol
Meena Dilip, Raghavi Abhilesh Bembey, Mitakshara Chawla, Ajay Chauhan. Groundwater:- A Familial Curse Sub-Acute Arsenic Poisoning Successfully Treated with Chelating Therapy:- A Case Report Series. Int Clinc Med Case Rep Jour. 2024;3(12):1-9.