Lead poisoning: case studies

Gordon, JN; Taylor, Alan; Bennett, Peter N.

doi:10.1046/j.1365-2125.2002.01580.x

Cited by 95 publications

(59 citation statements)

References 52 publications

(42 reference statements)

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“…Lead-related anemia is a late complication when blood lead levels exceed 50 mcg/dL. 6 The anemia is typically hypochromic and microcytic with basophilic stippling of the erythrocytes like it was the case in our patient. In addition, lead increases errors by DNA and RNA polymerases, potentially resulting in somatic and germline mutations.…”

Section: Discussion Lead Toxicitysupporting

confidence: 59%

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Lead Poisoning in an Adult: Lead Mobilization by Pregnancy?

Riess

Halm²

2007

J GEN INTERN MED

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We report a case of acute lead poisoning in an adult female who had last been exposed to lead 7 years ago. She presented with abdominal pain, knee pain, and neurological symptoms, hypertension, chronic kidney disease, and anemia with basophilic stippling and lead gum lines. Compared to during her recent pregnancy, her lead level had almost tripled in 5 months to 81 mcg/dL. Chelation therapy was initiated and improved the patient's symptoms and lead level significantly. In the absence of any new lead exposure or other reasons for increased bone turnover, this acute lead increase was likely due to skeletal mobilization caused by increased resorption from mineralized tissue during and after her pregnancy. This case report illustrates the seriousness of long-term health effects associated with lead poisoning at a multi-organ level, even years after the initial exposure. Thus, patient care should not be limited to the acute treatment of increased lead levels, but also include prevention of increased mobilization and bone turnover and appropriate patient education. In this context, we review various aspects of lead toxicity, especially during pregnancy and lactation.

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Section: Discussion Lead Toxicitysupporting

confidence: 59%

“…1,6 Neurological symptoms can range from fatigue, headache, and lethargy to peripheral neuropathy, severe convulsions, encephalopathy, and coma. Gastrointestinal symptoms include anorexia and abdominal cramps.…”

Section: Discussion Lead Toxicitymentioning

confidence: 99%

Lead Poisoning in an Adult: Lead Mobilization by Pregnancy?

Riess

Halm²

2007

J GEN INTERN MED

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“…Moreover, loss of appetite and weakness are more common in patients with plumbism than in healthy adults [14]. We searched the PubMed database from 2000 to 2013, and found 10 reported patients with acute-onset symptoms of lead intoxication (Table 2) [5,8,[16][17][18][19][20]. Six of these 10 patients had occupational lead exposure, and nine underwent chelation therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, many patients who presented with severe lead poisoning had lower blood lead concentrations (< 40 µg/dL) [7], suggesting a need for other indicators for early-stage diagnosis of plumbism. Lead is an electropositive metal with a high affinity for sulfhydryl groups, and inhibits 5-aminolevulinic acid dehydratase and ferrochelatase [8]. A high urinary δ-ALA concentration or blood zinc protoporphyrin level may therefore be useful for diagnosing lead intoxication, especially in patients with an acceptable blood lead concentration despite symptoms of lead intoxication.…”

Section: Discussionmentioning

confidence: 99%

Lead Intoxication Treated With D-Penicillamine

Iijima

2014

J Med Cases

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A 36-year-old man was admitted to our hospital with abdominal pain, nausea, weight loss and malaise. He had worked as a painter for 2 months. Laboratory testing showed anemia, liver dysfunction and elevated blood lead concentration. After administration of oral D-penicillamine, his urinary lead excretion increased significantly. His abdominal pain resolved after 5 days. His clinical course was otherwise uneventful. His anemia and liver dysfunction resolved after 2 months. His blood lead concentration remained normal for a year after discharge without recurrence of plumbism. Physicians should be aware of the clinical features of plumbism because early diagnosis is difficult.

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“…Blood lead may remain elevated for years after cessation of long exposure, due to remobilization from bone. 1 It appears that bone-Pb may be a more accurate and appropriate index of longterm cumulative exposure compared with blood-Pb. 2 This has led to the development of in vivo measurements of Pb in bone by X-ray fluorescence (XRF) including K-XRF 3 and L-XRF.…”

Section: Introductionmentioning

confidence: 99%

Determination of lead in bone by electrothermal atomic absorption spectrometry with Zeeman effect background correction

Pereira¹,

Luna²,

Herms³

et al. 2004

J. Braz. Chem. Soc.

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Um método para a determinação de traços de Pb em ossos por espectrometria de absorção atômica é descrito. Boas precisão e exatidão foram obtidas utilizando-se calibração externa com padrões aquosos e NH 4 H 2 PO 4 como modificador. O limite de detecção alcançado foi de 0,07 ng mL -1 na solução de leitura, correspondendo a 0,022 g g -1 na amostra original. Conseqüentemente, o limite de quantificação encontrado foi de 0,23 ng mL -1 . Uma precisão de 3,5% foi obtida na leitura de 400 ng de Pb na presença da matriz. A exatidão do procedimento foi confirmada pela boa concordância entre os valores certificado e encontrado na análise de um material certificado de referência (NIST SRM 1846, bone meal).A simple method for measuring trace levels of Pb in bone by electrothermal atomic absorption spectrometry is described. It is shown that Pb can be accurately measured with good precision and accuracy using external calibration with aqueous Pb analytical solutions containing NH 4 H 2 PO 4 as modifier. The detection limit was found to be 0.07 ng mL -1 , corresponding to 0.022 g g -1 in the original sample. Consequently, the limit of quantification was found to be 0.23 ng mL -1 . The precision of the procedure, expressed by the relative standard deviation, was 3.5% for 400 ng Pb in sample measurements. The accuracy of the procedure was confirmed by the good concordance between found and certified values in the analysis of a bone meal certified reference material, NIST SRM 1846.

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Lead poisoning: case studies

Cited by 95 publications

References 52 publications

Lead Poisoning in an Adult: Lead Mobilization by Pregnancy?

Lead Poisoning in an Adult: Lead Mobilization by Pregnancy?

Lead Intoxication Treated With D-Penicillamine

Determination of lead in bone by electrothermal atomic absorption spectrometry with Zeeman effect background correction

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