Lead Poisoning in an Adult: Lead Mobilization by Pregnancy?

Abstract

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.

Successful Treatment of Multiorgan Toxicity Induced by Explosive Agent With Repeated Hemodialysis: A Case Report

“…Hemodynamic disorders in our patient, such as hemolysis, leukocytosis, and imbalanced electrolytes, could be assumed to be due to the entrance of these hazardous substances into the bloodstream, rupturing the blood cells. As reported by other authors, hypoactivity of aminolevulinic acid dehydrase, which involves heme biosynthesis, was observed after lead poisoning (8). The significantly decreased Hb in our case could be explained partly by this mechanism.…”

Heavy metal in drinking water its effect on human health and its treatment techniques – a review

“…( Gidlow, 2004;Riess and Halm, 2007;Venkatesh, 2004). In women during pregnancy, even low concentration of lead can effect on the newborn baby, low birth weight and miscarriage (Bellinger, 2005;McMichael et al, 1986).…”

Anestesia em paciente com saturnismo: relato de caso

“…Lead interferes competitively with divalent cations (calcium, magnesium, and zinc), impairs mitochondrial oxidative phosphorylation and intracellular signaling systems, causes neuroendocrine and smooth muscle contraction dysfunction 7 . Lead has a high affinity for sulfhydryl groups.…”

“…Inhibition of three important enzyme of the heme biosynthesis-5 delta-aminolevulinic acid dehydratase (ALA-D), coproporphyrinogen oxidase, and ferrochelatase-causes hematological changes. Anemia, typically hypochromic and microcytic with basophilic stippling of erythrocytes 7 , is a late complication 8 .…”