Two cases of acute lead poisoning due to occupational exposure to lead

Ogawa, Masanori; Nakajima, Yoshiaki; Kubota, Ryuichi; Endo, Yuichi

doi:10.1080/15563650701816448

Cited by 47 publications

(17 citation statements)

References 10 publications

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“…Anemia is therefore not observed in all patients with lead intoxication, and bone marrow biopsy does not show specific findings [18]. It should be noted that the hemoglobin concentration was above 10 g/dL in three cases (cases 3, 5 and 6) despite high blood lead concentrations [8,15,17]. Basophilic stippling, caused by aggregation of ribonucleic acid within erythrocytes due to inhibition of pyrimidine 5'-nucleotidase [3,8], was observed in seven of the cases.…”

Section: Discussionmentioning

confidence: 99%

“…The period of lead exposure was reported in only three cases. Although most of the patients had symptoms such as abdominal pain, malaise, headache, nausea and constipation, they did not seek treatment from a hospital or their local doctor while they could still tolerate the symptoms, leading to delays in diagnosis and treatment [17]. In five patients (cases 5, 6, 8, 9 and 10), abdominal pain led to consultation with a doctor even though preceding nonspecific complaints such as fatigue, malaise and headache had been tolerated [5,17,[19][20][21].…”

Section: Discussionmentioning

confidence: 99%

“…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%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Lead Intoxication Treated With D-Penicillamine

Iijima

2014

J Med Cases

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“…Peripheral neuropathies may be seen, and as blood levels rise further neuro-cognitive defects progressing to frank encephalopathy, seizures and even death can occur. 1,3 Most commonly the picture is of chronic lead intoxication, often due to occupational exposure over a long period of time (Table 3). These cases usually present insidiously with non-specific symptoms affecting multiple organ systems.…”

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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“…Two cases of acute lead poisoning due to occupational exposure to lead were described by Ogawa et al (2008). The patients were engaged in stripping off antirust compounds including Pb from a bridge and re-painting it at the same work place.…”

Section: Acute Exposurementioning

confidence: 99%

Lead Exposure and Environmental Health

Patočka¹,

Kuča²

2016

MMSL

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SummaryLead (Pb), which is widely used in industry, is a common element found in low concentrations in the Earth's crust. Lead has been used since prehistoric times. As a highly toxic heavy metal, the pollution and exposure risks of lead are of widespread concern for human health. This environmental contaminant causing irreversible health effects mainly in children. Especially children under the age of six are most at risk for lead poisoning. Lead toxicity causes hematological, gastrointestinal, and neurological dysfunction. Symptoms are usually noted with blood lead greater than 2 μmol/litre. Severe or prolonged exposure may also cause chronic nephropathy, hypertension, and reproductive impairment. Lead inhibits some enzymes, alters cellular calcium metabolism, stimulates synthesis of binding proteins in kidney, brain, and bone, and slows down nerve conduction. The emission sources and pathological effects of lead are discussed.

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Two cases of acute lead poisoning due to occupational exposure to lead

Cited by 47 publications

References 10 publications

Lead Intoxication Treated With D-Penicillamine

Lead Intoxication Treated With D-Penicillamine

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

Lead Exposure and Environmental Health

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