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Arsenic occurs naturally in the Earth's crust, but anthropogenic arsenic emissions have surmounted the emissions from important natural sources such as volcanism. Inorganic arsenicals exhibit acute and chronic toxicities in virtually all cell types and tissues, and hence arsenic intoxication affects multiple systems. Whereas acute arsenic intoxication is rare and relatively easy to diagnose, chronic arsenic intoxication (CAsI) is common but goes often misdiagnosed. Based on a review of the literature as well as our own clinical experience, we propose a chronic arsenic intoxication diagnostic score (CAsIDS). A distinctive feature of CAsIDS is the use of bone arsenic load as an essential criterion for the individual risk assessment of chronic arsenic intoxication, combined with a systemic clinical assessment. We present clinical examples where CAsIDS is applied for the diagnosis of CAsI, review the main topics of the toxicity of arsenic in different cell and organ systems and discuss the therapy and prevention of disease caused or aggravated by chronic arsenic intoxication. CAsIDS can help physicians establish the diagnosis of CAsI and associated conditions.<\/jats:p>","DOI":"10.1002\/jat.3512","type":"journal-article","created":{"date-parts":[[2017,8,31]],"date-time":"2017-08-31T08:10:03Z","timestamp":1504167003000},"page":"122-144","source":"Crossref","is-referenced-by-count":18,"title":["Chronic arsenic intoxication diagnostic score (CAsIDS)"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4250-7734","authenticated-orcid":false,"given":"Sergio Ulhoa","family":"Dani","sequence":"first","affiliation":[{"name":"Medawar Institute for Medical and Environmental Research Acangau Foundation  Paracatu MG Brazil"},{"name":"Department of General Internal Medicine St. Gallen Cantonal Hospital  Switzerland"},{"name":"PizolCare Praxis Wartau  Tr\u00fcbbach Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard Franz","family":"Walter","sequence":"additional","affiliation":[{"name":"International Neuroscience Institute  Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,8,31]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.1103988"},{"key":"e_1_2_8_3_1","unstructured":"Acangau Foundation. 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