An event is serious (FDA MedWatch definition) when the patient outcome is:

  • death

  • life-threatening

  • hospitalisation

  • disability

  • congenital anomaly

  • requires intervention to prevent permanent impairment or damage

Drug overdose

A 39-year-old woman developed peripheral neuropathy and various other toxicities due to inorganic arsenic poisoning.

The woman was hospitalised for 1.5 months with pancytopenia, GI disorders, pathological liver tests, patchy alopecia, a macular rash, rhabdomyolysis, renal failure, and progressing weakness and peripheral neuropathy progressing to quadriplegia and dependance on a ventilator, resulting in her transfer to the ICU. Laboratory analyses of first samples showed total arsenic levels in her serum and urine of 290 µg/kg and 2000 µg/L, respectively, and she was diagnosed with arsenic poisoning from an estimated dose of ≥ 1000mg during the week prior to the urine sample. Electromyography identified generalised axonal polyneuropathy.

The woman received chelating therapy with succimer, but clinical improvement was slow, and she was dependent on a ventilator for a total of 44 days. She was subsequently transferred to the neurology department for 4 weeks, then a rehabilitation hospital for 8 months, before discharge in a wheelchair. At 5 years’ follow-up, she could walk unassisted for short distances, but residual paraesthesia and weakness in her distal lower extremities and hands persisted. The source of the arsenic poisoning was not determined.

FormalPara Key words

Drug-overdose - Arsenic - drug-induced - Various-toxicities - Peripheral-nervous-system-diseases - overdose