Recovery from severe arsenic-induced peripheral neuropathy with 2,3-dimercapto-l-propanesulphonic acid

Case Report: A 33-year-old female with a 1.5-year history of multisystem il lness was diagnosed with arsenic poisoning. Twenty-four-hour urine arsenic was 1030 mug/dL (normal 0-99) and root hair arsenic was 130 mug/g (normal 0 -3). Despite treatment with succimer meso-2,3-dimercaptosuccinic acid, her neuropathy progressed to ventilator dependence and quadriplegia. Subsequent intravenous treatment with 2,3-dimercapto-1-propanesulfonic acid sodium sa lt was associated with arsenic diuresis, marked neuropathic improvement, an d extubation, At 1-year follow-up, neuropathy was limited to mild distal lo wer extremity weakness and sensory loss, The use of 2,3-dimercapto-1-propan esulphonic acid in the treatment of severe arsenic neuropathy was associate d with increased urinary elimination of arsenic and dramatic clinical recov ery.