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Rev Med Inst Mex Seguro Soc. 2005 Jan-Feb;43(1):57-60.  [Arsenic intoxication: information and case report]. [Article in Spanish]  Bucio Jurado W

Arsine intoxication is a true medical emergency with a high fatality rate, characteristic of acute and massive hemolysis.

Inhalation of 250 ppm of arsine gas is instantly lethal. Exposure to 25 to 50 ppm for 30 minutes is lethal. Arsine is a colorless gas with a garlic scent, entering the organism by breathing and passing directly into the circulation. Its hemolytic activity is due to its ability to cause a fall in erythrocyte-reduced glutathione content.

Manifestations are suggestive of a general toxic state with alterations of consciousness, from confusion until delirium, crash, hematuria, jaundice and renal insufficiency.

This can generate confusion and difficulty in the diagnosis and in the opportune treatment to avoid death or sequelae.

This type of intoxication must be suspected in electrolysis process workers or those working with lead, copper, zinc, iron, gold, silver and tin. In the present case, sources for arsenic ingestion in the organism were discarded and the presence of arsine in the workplace was confirmed. In spite of the administered treatment, the patient experienced renal insufficiency

PMID:  15998481