Severe Neurotoxicity Following Ingestion of Tetraethyl Lead

Abstract

Organic lead compounds are potent neurotoxins which can result in death even from small exposures. Traditionally, these compounds are found in fuel stabilizers, anti-knock agents, and leaded gasoline. Cases of acute organic lead intoxication have not been reported for several decades. We report a case of a 13-year-old Iraqi male who unintentionally ingested a fuel stabilizer containing 80-90% tetraethyl lead, managed at our combat support hospital. The patient developed severe neurologic symptoms including agitation, hallucinations, weakness, and tremor. These symptoms were refractory to escalating doses of benzodiazepines and ultimately required endotracheal intubation and a propofol infusion. Adjunctive therapies included chelation, baclofen, and nutrition provided through a gastrostomy tube. The patient slowly recovered and was discharged in a wheelchair 20 days after ingestion, still requiring tube feeding. Follow-up at 62 days post-ingestion revealed near-resolution of symptoms with residual slurred speech and slight limp. This case highlights the profound neurotoxic manifestations of acute organic lead compounds.

Adipose tissue: Another target organ for lead accumulation? A study on sardinian children (Italy)

“…The greatest danger of lead poisoning is to the central nervous system (Abadin and Pohl, 2010) since the liposoluble lead-alkyls can easily cross the blood-brain barrier, with extremely harmful consequences for the organism (Abadin and Pohl, 2010;J€ arup et al, 2003;Lidsky and Schneider, 2003;Marchetti, 2003;Rai et al, 2010;Wang et al, 2006). In fact, acute tetraethyl lead poisoning can have both systemic effects, such as compromised hepatic, renal, pulmonary and cardiovascular functions (Dioka et al, 2004;Simões et al, 2010;Winnik et al, 2004), and neurotoxic effects, such as encephalopathy, behavioral changes, nervousness and hallucinations (Lata et al, 1999;Tenenbein, 1997;Winnik et al, 2004;Wills et al, 2010).…”

Intubations and airway management: An overview of Hassles through third millennium

“…Assessment by experienced medical staff (rather than physiological variables) is significant enough to determine the requirement of intubation in poisoned patients with reduced GCS. [ 63 ] Hardcastle and Goff,[ 64 ] reported GCS (less than 8) as the most common indication for intubation, typically in the polytrauma patient with suspected head injury due to motor vehicle accident. Emergency doctors managed 100% of definitive airway in-hospital and RSI was the favored method.…”

Heavy Metal Toxicity in Humans and its Preventive and Control Measures

“…The Pb exposed children of occupational workers living in the vicinity of Pb smelter/battery recycle plants had significantly higher blood Pb and their hematopoietic, renal and hepatic functions were impaired [94]. Unintentional ingestion of a stabilizer containing Pb, by a 13-yr old Iraqi male, developed severe neurologic symptoms including agitation, hallucinations, weakness and tremor [95].…”