Acute Arsine Poisoning Confirmed by Speciation Analysis of Arsenic Compounds in the Plasma and Urine by HPLC-ICP-MS

Abstract

Objectives: Arsine, a potent hemolytic agent, is widely used in the semiconductor industry. We report a case of arsine poisoning confirmed by arsenic speciation analysis in serum and urine that occurred in a recycling factory. Case: A male worker in his twenties noticed hematuria 3 h after finishing work and was admitted into our hospital 34 h later. Speciation analysis of arsenics in serum and urine samples was performed using HPLC-ICP-MS. On admission, anemia, hematuria, and renal and liver dysfunction were observed. His clinical condition had improved remarkably after 5-days of transfusion and 4 units of RBC transfusion. The total arsenic content in the serum was 244.8 μg/l at admission and 97.1 μg/l at discharge. In the speciation analysis, four kinds of As compounds derived from arsine metabolism were detected in serum and urine. The concentrations of arsenite (AsIII), arsenate (AsV), monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA) in serum at admission were 45.8, 5.2, 17.9 and 9.3 μg/l, respectively. The concentrations of AsIII, AsV and MMA decreased with biological half-lives (BHL) of 30.1, 43.0, and 96.3 h, respectively, while that of DMA was increased towards discharge. The urinary AsIII, AsV, MMA, and DMA concentrations at discharge were 384.5, 20.8, 547.4 and 1816.3 μg/g creatinine, respectively. These concentrations in urine subsequently decreased and their BHL was 15 days. Conclusion: The results of the present study suggest that arsine is quickly metabolized to AsIII and then metabolized via MMA to DMA in humans.