TY - JOUR T1 - RHabdomyolysis in fatal arsenic trioxide poisoning AU - Sanz P, Corbella J, Nogué S, Munné P, Rodriguez-Pazos M Y1 - 1989/12/15 N1 - 10.1001/jama.1989.03430230043020 JO - JAMA SP - 3271 EP - 3271 VL - 262 IS - 23 N2 - To the Editor. —  We report a case of fatal arsenic poisoning with acute renal failure, circulatory collapse, and severe rhabdomyolysis.Report of Case.—  A 23-year-old man came to our hospital 1 hour after voluntary ingestion of 20 g of arsenic trioxide. On admission he was asymptomatic. He was treated with ipecac syrup, activated charcoal, and dimercaprol (3 mg/kg intramuscularly every 4 hours).Within 8 hours, arterial hypotension (95/50 mm Hg) and anuria ensued. Plasma expanders were perfused and a progressive rise of the central venous pressure, without the reestablishment of diuresis, was observed. Nine hours later, when the creatinine level was 300 μmol/L and the creatine phosphokinase level 1223 U/L, it was decided to carry out hemodialysis followed by a dopamine infusion due to the progressive hypotension.Evolution was characterized by refractory shock, the increase of rhabdomyolysis (creatine phosphokinase level, 31 350 U/L), hepatic dysfunction (aspartate aminotransferase level, 550 SN - 0098-7484 M3 - doi: 10.1001/jama.1989.03430230043020 UR - http://dx.doi.org/10.1001/jama.1989.03430230043020 ER -