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Hi Grainne
There are many non-toxic dietary forms of arsenic present in fish, seafood and animals that are fed on foodstuffs derived from marine sources. It is not uncommon to see high levels
of urinary arsenic related to the diet.
We always recommend that patients do not eat any fish or seafood for at least 5 days prior to providing a urine sample (1st morning void). If the sample is then shown to contain
arsenic we would send it for speciation analysis which is used to show the concentration of the different forms of As and will help determine whether exposure is to the toxic forms (As III or AsV) or the dietary forms.
If you contact me directly rather than via the list server I will be able to give you details of a lab in the UK that does this.
Kind regards
Chris
------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/Dear all,
I would be grateful for any thoughts on the case below.
5 year old boy presented with D+V illness, rash, fall in GCS, encephalopathy, ataxia, weakness and required ventilation in PICU (due to the severity of his neurological condition).
Nerve conduction studies showed predominantly axonal loss peripheral neuropathy. CSF total protein 6g/l. MRI brain nil significant.
He was treated as a possible Gullian Barre variant and was given IV immunoglobulin and steroids. Clinically he improved with this treatment.
Urine arsenic requested shortly after admission was 223 nmol/mmol creat (0-12.9 nmol/mmol creat).
A repeat sample was sent (about 4 weeks into his hospital admission) and although he was clinically much improved his urine arsenic had increased to 730 nmol/mmol creat.
A further urine arsenic sample 1 week later was 40 nmol/mmol creat and urine cobalt (which had been normal) had increased 5.9 (0-2.0) nmol/mmol creat.
Mother and sibling urine arsenics are normal.
Public Health have not identified a source for the elevated urinary arsenic. He has a normal diet.
We are having some difficulty piecing this all together, so would be grateful if anyone has any ideas.
Many thanks,
Grainne
Consultant Chemical Pathologist
Belfast Trust
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