Abstract
Background
Symptomatic arsenic toxicity has not been associated with terracotta pottery despite
thousands of years of use in food storage and preparation. We describe a case of chronic
arsenic toxicity from undiagnosed pica involving the ingestion of terracotta pots.
Case Report
A 49-year-old woman with a history of anemia and abnormal uterine bleeding presented
to the Emergency Department complaining of lower extremity pain. She was also noted
to have chronic lower extremity paresthesia, constipation, and fatigue. She admitted
to ingesting glazed and unglazed terracotta pots for the past 5 years. This unusual
craving was thought to be a manifestation of pica in the setting of chronic anemia.
The patient was found to have an elevated urinary arsenic concentration of 116 µg/24
h. An abdominal radiograph showed opacifications throughout her bowel, and she received
whole bowel irrigation.
Why Should an Emergency Physician Be Aware of This?
Pica is a common behavior in certain populations. Practicing clinicians should be
familiar with the complications of pica, including chronic arsenic toxicity and its
associated array of nonspecific symptoms.
Keywords
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References
- Chronic health effects in people exposed to arsenic via the drinking water: dose-response relationships in review.Toxicol Appl Pharmacol. 2004; 198: 243-252
- Pica: common but commonly missed.J Am Board Fam Pract. 2000; 13: 353-358
- Leaching of arsenic from glazed and nonglazed potteries into foods.Sci Total Environ. 2016; 569–70: 1530-1535
- A meta-analysis of the worldwide prevalence of pica during pregnancy and the postpartum period.Int J Gynaecol Obstet. 2016; 133: 277-283
- Does arsenic pose a health concern after consumption of clay products?.Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2021; 38: 113-124
- Determination of arsenic leaching from glazed and non-glazed Turkish traditional earthenware.Sci Total Environ. 2011; 409: 2993-2996
- Goldfrank's toxicologic emergencies.11th ed. McGraw-Hill Education, New York2019
- Arsenic contamination in groundwater in Bangladesh: implications and challenges for healthcare policy.Risk Manag Healthc Policy. 2018; 11: 251-261
- A review of groundwater arsenic contamination in Bangladesh: the Millennium Development goal era and beyond.Int J Environ Res Public Health. 2016; 13: 215
- Groundwater arsenic contamination in Bangladesh–21 Years of research.J Trace Elem Med Biol. 2015; 31: 237-248
- Randomized placebo-controlled trial of 2,3-dimercaptosuccinic acid in therapy of chronic arsenicosis due to drinking arsenic-contaminated subsoil water.J Toxicol Clin Toxicol. 1998; 36 (Erratum in: J Toxicol Clin Toxicol 1999;37:525): 683-690
Article info
Publication history
Published online: June 07, 2022
Accepted:
June 4,
2022
Received in revised form:
April 29,
2022
Received:
February 14,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
