Lead Poisoning and Recurrent Abdominal Pain

Shiri, Rahman; Ansari, Mostafah; Ranta, M.; Falah‐Hassani, Kobra

doi:10.2486/indhealth.45.494

Cited by 43 publications

(38 citation statements)

References 8 publications

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“…In some cases appendicectomies and even laparotomies have been carried out before eventually arriving at the diagnosis of lead poisoning. 4,5 The pattern of abdominal pain suffered by our patient is characteristic, with paroxysms of severe, colicky abdominal pain. The rise in ALT that we observed with symptomatic episodes has also been reported elsewhere as the only routine biochemical abnormality in lead poisoning.…”

Section: Discussionmentioning

confidence: 99%

Acute lead intoxication from medications purchased online presenting with recurrent abdominal pain and encephalopathy

Barber

Jacyna

2011

J R Soc Med

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This case illustrates the importance of eliciting the use of alternative and non-prescription medicines when taking histories and also considering lead poisoning in the differential of unexplained abdominal pain. CaseA previously well 26-year-old Asian man presented acutely with a two-day history of severe, colicky, central upper abdominal pain, associated with vomiting and constipation. There were no precipitating factors and the pain was not relieved by simple analgesia. He was on no prescribed medication and denied taking any other drugs. Clinical examination was unremarkable, as was an abdominal radiograph. Routine haematology and biochemistry blood tests, including blood film, were normal apart from a raised Alanine Transaminase (ALT) at 222 IU/mL. Although in great distress initially, his symptoms resolved spontaneously within two days and he was discharged.Two weeks later he presented with identical symptoms, having been symptom-free in the interim. ALT was again moderately raised at 180 IU/mL. Gastroscopy and ultrasound of the abdomen were both normal. An abdominal CT scan was normal apart from slight terminal ileal thickening. However, a subsequent colonoscopy showed a normal terminal ileum; histology revealed only mild non-specific inflammation and both ZN staining and TB culture of the biopsies were negative. Chest X-ray, Mantoux test and Yersinia serology were also negative. During this admission he exhibited behavioural disturbance, was transiently disoriented and threatened suicide. Although these features settled, a psychiatric assessment was undertaken. It transpired the patient had recently consulted his GP about marital difficulties due to erectile dysfunction, for which the GP had declined the patient's request for Viagra. Again all of his symptoms settled spontaneously, his ALT normalized and he was discharged.Shortly after discharge however, he was readmitted with further abdominal pain and again displaying erratic behaviour. On this occasion an abdominal radiograph showed some high density specks in the colon (Figure 1). ALT was raised at 390 but again returned to normal soon after admission. A comprehensive panel of blood tests screening for causes of liver disease was entirely negative and magnetic resonance cholangiopancreatography (MRCP) revealed a normal liver and biliary system. In view of the pain, constipation and psychological symptoms, urine and blood were sent for porphyria testing. Although the urine porphyrin:creatinine ratio was markedly raised at 230 (normal range 0-35), the absence of raised urinary porphobilinogen during an acute attack meant that acute intermittent porphyria was extremely unlikely. The differential for raised urinary por-

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Section: Discussionmentioning

confidence: 99%

Acute lead intoxication from medications purchased online presenting with recurrent abdominal pain and encephalopathy

Barber

Jacyna

2011

J R Soc Med

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“…Other symptoms of Pb toxicity include muscle pain, droopiness and work-related nasal symptoms frequently observed in Pb workers [85]. Three blood brothers involved in pottery glazing suffered from repeated episodes of severe abdominal pain, nausea, vomiting, constipation and anemia due to Pb toxicity [86]. Uniformed service personnel and residents of Lower Manhattan who were exposed to the air at Ground Zero following September 11, 2001, for extended periods of time, exhibited severe respiratory and digestive problems, skin rashes, sleeplessness, anxiety, lethargy, elevated blood pressure and recurrent headaches [87].…”

Section: Toxicity Symptoms and Associated Diseasesmentioning

confidence: 98%

Heavy Metal Toxicity in Humans and its Preventive and Control Measures

Gupta¹,

Gupta²

2011

Current Nutrition & Food Science

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The main threats to human health from heavy metals are associated with exposures to arsenic (As), lead (Pb), cadmium (Cd), and mercury (Hg). In nature, heavy metal toxicities occur in all living organisms. The consequences of these toxicities have been described in humans. An important aspect of heavy metal toxicities resulting in carcinogenicity is due to the generation of reactive oxygen and nitrogen species e.g. super oxides, hydro peroxides and nitric oxide. Consumption of food crops grown in regions with toxic levels of heavy metals and consumption of live stock products fed produce from these regions could result in heavy metal toxicity in humans. Heavy metals, when in excess quantities, accumulate chiefly in the blood, liver and kidneys. However, researchers suggest that aluminum (Al) may be more likely to accumulate in the brains of persons whose diets are Magnesium (Mg)-deficient. In general, heavy metal toxicities in humans are not common under normal conditions. Most toxicities are caused by environmental and/or genetic abnormalities, from excessive intake, by deliberate or accidental overdose, or from induced deficiencies. Effective measures to control metal toxicities in humans include gastric lavage, ascorbic acid intake and divalent cation therapy, such as the use of calcium (Ca) and zinc (Zn). The use of a variety of chelating agents in the acute toxicity phase has also been found useful. Protective legislation against the use of metal alloy cooking utensils is the long-term control strategy. Future studies need to identify the mechanism of action for toxicity, because at present only a few have been elucidated in this context.

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“…Abdominal pain is the foremost common complaints in the emergency department (ED). Lead toxicity is a rare cause of abdominal pain [11][12][13] and is the foremost frequent complaints encountered within the emergency department. Lead toxicity has been represented within the occupational, gastroenterology, and foreign literature, but scientists were unable to search out reports of lead toxicity as a reason for abdominal pain within the medicine literature.…”

Section: Lead Poisoningmentioning

confidence: 99%

Lead Exposure in Different Organs of Mammals and Prevention by Curcumin–Nanocurcumin: a Review

Pal

Sachdeva

Gupta

et al. 2015

Biol Trace Elem Res

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Chronic lead exposure is related to many health diseases in mammals. Exposure to lead forms reactive oxygen species reducing body antioxidant enzymes inflicting injury to numerous macromolecules or cell necrosis. Recent studies have revealed oxidative stress as the vital mechanism for lead toxicity. Lead is found to be toxic to several organ systems such as hematopoietic, skeletal, renal, cardiac, hepatic, and reproductive systems and extremely toxic to the central nervous system (CNS). Curcumin, an active ingredient of the dietary spice, and nanocurcumin, a nanoform of curcumin, are found to decrease toxicity due to lead in various organ systems in mouse models. Higher bioavailability, chelating property, and retention time of nanocurcumin over bulk curcumin may pave the way to expand the utility of nanocurcumin to remove lead toxicity from various organ systems within humans.

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Lead Poisoning and Recurrent Abdominal Pain

Cited by 43 publications

References 8 publications

Acute lead intoxication from medications purchased online presenting with recurrent abdominal pain and encephalopathy

Acute lead intoxication from medications purchased online presenting with recurrent abdominal pain and encephalopathy

Heavy Metal Toxicity in Humans and its Preventive and Control Measures

Lead Exposure in Different Organs of Mammals and Prevention by Curcumin–Nanocurcumin: a Review

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