Clinical
description
Unless
immediately fatal (i.e., with a high-dose exposure), exposure to
the poisonous gas arsine or stibine typically results in signs
and symptoms due to massive hemolysis that occurs anywhere from 1 to
24 hours after exposure. Generalized weakness, dark urine, jaundice,
and delirium are common signs and symptoms after arsine exposure.
Subacute symptoms (1–3 weeks) are notable for a painful peripheral
neuropathy and neuropsychological symptoms (e.g., memory loss,
irritability, and confusion).
Laboratory criteria for diagnosis
- Elevated
blood or urinary arsenic levels for an arsine exposure (24-hour urine
collection preferred), or elevated urinary antimony level for a stibine
exposure, OR
- Detection
of arsine or stibine in environmental samples
Case classification
- Probable: a clinically compatible case with a high index of suspicion (reliable
intelligence or patient history) for arsine or stibine exposure
- Confirmed: a clinically compatible case with laboratory confirmation or with
an epidemiological link to a laboratory-confirmed case
Additional resources
- Goldfrank
LR, Flomenbaum ME, Lewin NE, et al., editors. Goldfrank's Toxicologic
Emergencies. 7th ed. McGraw-Hill; 2002.
- Fowler BA, Weissberg
JB. Arsine poisoning. NEJM 1974 Nov 28;291(22):1171–4.
- Hatlelid KM, Brailsford
C, Carter DE. Reactions of arsine with hemoglobin. J Toxicol Environ
Health 1996 Feb 9;47(2):145–57.
- Pinto SS. Arsine
poisoning: evaluation of the acute phase. J Occup Med 1976 Sep;18(9):633–5.
This
document is based on CDC’s best current information. It may
be updated as new information becomes available.
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