A 17-year-old healthy female presented with altered mentation after a
fall, workup revealed new onset APML. Chemotherapy was initiated. She
developed MODS requiring ECMO and CVVHDF. Two days after discontinuation
of support, patient developed acute worsening mentation, emesis,
diarrhea, tachycardia, fever, creatinine of 9.58 mg/dL, and prolonged
QTc-582, indicating arsenic poisoning from chemotherapy. Initial
management goals are decontamination and hemodynamic stabilization.
Hemodialysis can be treatment of toxicity if chelation is not an option.
This is the youngest patient to receive hemodialysis for the treatment
of acute arsenic toxicity in the literature who was not hemodialysis