@article{vrotsos2014arsenic,
  title = {Arsenic Exposure as a Cause of Persistent Absolute Eosinophilia},
  author = {Elena Vrotsos and Raul Martinez and Joseph Pizzolato and Antonio Martinez and Vathany Sriganeshan},
  year = 2014,
  url = {https://ibimapublishing.com/articles/JMED/2014/230675/},
  journal = {JMED Research},
  volume = 2014 (2014),
  pages = 5,
  doi = 10.5171/2014.230675,
  abstract = {Arsenic exposure and toxicity is still a major health concern. Millions of people in Asia rely on water supply contaminated with arsenic, as mentioned in Polya (2009). Arsenic can be detected in varying concentrations in all environmental media, as shown in the research done by Mondal (2010) and Paul (2013). It is released naturally into the air by volcanoes. Arsenic compounds are used to manufacture products in the agricultural industry including insecticides, herbicides, sheep dips, wood preservatives, fungicides, and medication for eradication of tapeworms in sheep and cattle. In addition arsenic compounds were used for at least a century in the treatment of syphilis, amoebic dysentery and trypanosomaiasis. Environmental sources of arsenic are wide and include food, water, soil and air. Arsenic toxicity can be divided into acute and chronic. The changes that can be seen with arsenic exposure are extensive and mostly non-specific like skin changes, peripheral sensorimotor neuropathy, diabetes mellitus, hypertension, pericarditis, thrombocytopenia, leukopenia, and eosinophilia. Herein we present a case of a 32 year old woman that was referred to the hemotology/oncology service for eosinophilia. Her medical history includes asthma as a child and depression. Her medications included Wellbutrin, Abilify, Melatonin and Vitamin D. She had persistent eosinophilia for several years. Extensive work-up including B12, folate, cortisol, HIV, ESR, CRP, JAK-2 mutation, BCR-ABL, PDGFRα/βwere negative. All the medications were discontinued, but her eosinophilia persisted. Several years after her initial presentation, heavy metal urine screen was ordered and came back with high level of arsenic, 144.5 mcg per gram creatinine. Eosinophilia is one of the non-specific symptoms that can be related to arsenic toxicity. Our case demonstrates the need for urine heavy metal screen when all other possibilities are ruled out. },
  keywords = {Eosinophilia, arsenic exposure, persistent absolute eosinophilia.},
  note = Article ID: 230675
}