Benzeeta Pinto1, Palvi Goyal, S J S Flora, K D Gill, Surjit Singh. 1. Department of Internal Medicine, Nehru Hospital, Postgraduate Institute of Medical Education and Research, 4th Floor, Block F, Room 16, Chandigarh, 160012, India.
Abstract
BACKGROUND: Ayurveda, Indian traditional system of medicine, is practiced commonly in South East Asia and in many parts of the world. Many ayurvedic drugs contain heavy metals and may lead to metal toxicity. Of these, chronic lead poisoning is the most common. Chronic arsenic poisoning following the use of ayurvedic medication, though reported, is rare. CASE REPORTS: We describe three patients who presented with features of chronic arsenic poisoning following prolonged ayurvedic medication use. The diagnosis of chronic arsenic poisoning was confirmed by high arsenic levels in the blood, urine, hair, and nails in all the three patients and in ayurvedic drug in two patients. The ayurvedic medication was discontinued and treatment with D-penicillamine started. At 6 months after treatment, blood arsenic levels returned to normal with clinical recovery in all of them. CONCLUSION: Arsenic poisoning following ayurvedic medication is much less common than lead poisoning, though mineral ayurvedic medicines may lead to it. We used D-penicillamine as chelator and all of them recovered. Whether withdrawal of medication alone or D-penicillamine also played a role in recovery is unclear and needs to be assessed.
BACKGROUND: Ayurveda, Indian traditional system of medicine, is practiced commonly in South East Asia and in many parts of the world. Many ayurvedic drugs contain heavy metals and may lead to metaltoxicity. Of these, chronic lead poisoning is the most common. Chronic arsenic poisoning following the use of ayurvedic medication, though reported, is rare. CASE REPORTS: We describe three patients who presented with features of chronic arsenic poisoning following prolonged ayurvedic medication use. The diagnosis of chronic arsenic poisoning was confirmed by high arsenic levels in the blood, urine, hair, and nails in all the three patients and in ayurvedic drug in two patients. The ayurvedic medication was discontinued and treatment with D-penicillamine started. At 6 months after treatment, blood arsenic levels returned to normal with clinical recovery in all of them. CONCLUSION:Arsenic poisoning following ayurvedic medication is much less common than lead poisoning, though mineral ayurvedic medicines may lead to it. We used D-penicillamine as chelator and all of them recovered. Whether withdrawal of medication alone or D-penicillamine also played a role in recovery is unclear and needs to be assessed.
Authors: D N Guha Mazumder; Craig Steinmaus; Partha Bhattacharya; Ondine S von Ehrenstein; Nilima Ghosh; Michael Gotway; Arabinda Sil; John R Balmes; Reina Haque; Meera M Hira-Smith; Allan H Smith Journal: Epidemiology Date: 2005-11 Impact factor: 4.822
Authors: Robert B Saper; Russell S Phillips; Anusha Sehgal; Nadia Khouri; Roger B Davis; Janet Paquin; Venkatesh Thuppil; Stefanos N Kales Journal: JAMA Date: 2008-08-27 Impact factor: 56.272