What are the symptoms of drinking water-related endemic arsenic poisoning?

The most common type of endemic arsenic poisoning is drinking water, which is a disease that poses a great threat to health. The patient's skin will change, leading to skin cancer, and other organs will be affected. Lung cancer, breast cancer, and bone cancer are all common complications.

1. Clinical manifestations

1. Specific manifestations

In the early stages, it often manifests as symptoms of peripheral neuritis, with symmetrical, centripetal sensory disturbances in the limbs, and abnormalities such as decreased pain and temperature sensation, numbness, and a sense of tingling. The muscles of the limbs are painful and weak in contraction, and there may even be difficulty in lifting and walking. The patient's hair is dry, brittle, and easily falls off.

2. Organ damage

There may be damage to the liver, kidneys, nervous system, blood system, cardiovascular system, and male reproductive system. It can induce skin cancer, breast cancer, kidney cancer, bladder cancer, lymphosarcoma, angiosarcoma, oral cancer, bone cancer, peritoneal and reproductive system tumors, etc.

2. Treatment Principles

1. Nutritional support;

2. Treat peripheral neuritis;

3. Treat skin lesions;

4. Use specific antidotes

Sodium dithiopropane sulfonate, 0.125~0.25g intramuscularly per day, one course of treatment is 3~5 days. 10% sodium thiosulfate can also be used. Adults should receive 10-20 ml of sodium thiosulfate intravenously once a day. One course of treatment is 3-5 days, and 3-5 courses of treatment should be continued.

3. Treatment Methods

1. Arsenic removal treatment

Currently, arsenic removal treatment mainly uses base compounds, the thiol group in its molecules can combine with arsenic ions in the body, and the combined products are quickly excreted from the body through the kidneys in the urine. At the same time, the thiol group can also release enzymes and tissues that have been bound to arsenic ions, restore the physiological functions of enzymes and tissues, and achieve a detoxification and arsenic removal effect. Commonly used ones include dimercaptopropanol, sodium dimercaptosuccinate, sodium dimercaptopropane sulfate, etc.

2. Symptomatic treatment

(1) For palmoplantar keratosis, 5% to 10% salicylic acid ointment, 20% urea ointment or 10% urea ointment can relieve pain, soften and dissolve keratinized matter, and even cause it to fall off. After the keratin falls off, vitamin E ointment can be used to prevent the skin from drying out. At the same time, auxiliary drugs such as retinoids and B vitamins can be given for symptomatic treatment. For patients with squamous cell carcinoma in situ or skin cancer, surgery may be considered.

(2) Peripheral vascular disease: First, patients should keep warm, quit smoking and engage in appropriate exercise; second, calcium channel blockers such as nifedipine can be used. For patients with more severe symptoms, α-receptor blockers and vasodilators such as benzylamine, nicotinic acid, etc. can be used. Traditional Chinese medicine such as hollyhock tablets or salvia miltiorrhiza can also be used, and auxiliary drugs such as vitamin E and vitamin B12 can be given at the same time.

(3) Other symptomatic supportive treatments are the same as general medical treatments, especially protecting liver function to maintain good metabolic and detoxification functions of the body.