Inhalation arsine poisoning: clinical features and treatment experience of 12 cases from a single incident

Background Arsine poisoning is a rare but life-threatening condition characterized by severe hemolysis. Clinical data on its management remain limited. This study describes the clinical features, diagnostic approach, and treatment experience of 12 patients from a single arsine poisoning incident. Methods Clinical data from the 12 patients were retrospectively collected. Presenting symptoms, diagnostic findings, and treatment strategies were summarized. Results Ten of the 12 patients survived. Arsenic was detected in cleaning wastewater and in the red blood cells of four patients, and, together with clinical hemolysis, supported the diagnosis of arsine poisoning. Common symptoms included headache, nausea, vomiting, abdominal pain, dizziness, chest tightness, and hematuria; headache, nausea, and vomiting frequently co-occurred. All patients received high-dose methylprednisolone, vitamin C + B6, and chelation therapy. The two non-survivors additionally received mechanical ventilation, therapeutic plasma exchange, dialysis, methylene blue, and transfusions; they died on day 3 from progressive cardiovascular failure secondary to acute hemolysis. Five other patients underwent therapeutic plasma exchange and dialysis and ultimately survived. Conclusions This case series highlights the clinical presentation, diagnostic workflow, and management of arsine poisoning in a well-characterized patient cluster. Early recognition and timely intervention may facilitate clinical management. The findings are descriptive and limited by the retrospective design and small sample size.