1/74. flour contamination as a source of lead intoxication.CASE REPORT: A 43-year-old man was hospitalized because of severe anemia and recurrent bouts of abdominal pain over 20 days. There was no known occupational exposure to toxins. Concomitantly, the patient's father complained of having the same symptoms. Familial lead poisoning was diagnosed when all 6 family members tested had high blood leads (31-64 micrograms/dL). RESULTS: Following detailed examination of the potential sources common to all members of the household, the cause of poisoning was determined to be corn flour containing 38.7 mg/g lead. physicians are reminded to consider lead poisoning in the differential diagnosis of individuals with unexplained symptoms, particularly those of abdominal discomfort and anemia.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
2/74. Lead induced anaemia due to traditional Indian medicine: a case report.Lead intoxication in adults without occupational exposure is a rare and unexpected event. The case of a western European is reported who had severe anaemia after ingestion of several ayurvedic drugs, obtained during a trip to india. Laboratory findings showed high blood lead concentrations, an increased urinary lead concentration, and an increased urinary excretion of delta-aminolaevulinic acid. Also, slightly increased urinary concentrations of arsenic and silver were found. physicians should be aware that with growing international travel and rising self medication with drugs from uncontrolled sources the risk of drug induced poisoning could increase in the future.- - - - - - - - - - ranking = 0.25keywords = intoxication (Clic here for more details about this article) |
3/74. lead poisoning after gunshot wound.CONTEXT: Despite the absence of symptoms in the majority of patients carrying lead bullet fragments in their bodies, there needs to be an awareness of the possible signs and symptoms of lead intoxication when bullets are lodged in large joints like knees, hips and shoulders. Such patients merit closer follow-up, and even surgical procedure for removing the fragments. OBJECTIVE: To describe a patient who developed clinical lead intoxication several years after a gunshot wound. DESIGN: Case report. CASE REPORT: A single white 23-year-old male, regular job as a bricklayer, with a history of chronic alcohol abuse, showed up at the emergency department complaining of abdominal pain with colic, weakness, vomiting and diarrhea with black feces. All the symptoms had a duration of two to three weeks, and had been recurrent for the last two years, with calming during interval periods of two to three weeks. Abdominal radiograms showed a bullet lodged in the left hip, with a neat bursogram of the whole synovial capsule. A course of chelating treatment using calcium versenate (EDTACaNa2) intravenously was started. After the chelation therapy the patient had recurrence of his symptoms and a radical solution for the chronic mobilization of lead was considered. A hip arthroplasty procedure was performed, leading to complete substitution of the left hip.- - - - - - - - - - ranking = 0.5keywords = intoxication (Clic here for more details about this article) |
4/74. Neuro-ototoxicity in andean adults with chronic lead and noise exposure.Brainstem auditory evoked responses and audiological thresholds were used as biomarkers for neuro-ototoxicity in adults with chronic lead (Pb) intoxication from long-term Pb exposure in ceramic-glazing work. Venous blood samples collected from 30 adults (15 men and 15 women) indicated a mean blood Pb level of 45.1 micrograms/dL (SD, 19.5; range, 11.2 to 80.0 micrograms/dL) and in excess of the world health organization health-based biological limits (men, 46.2 micrograms/dL; SD, 19.6; range, 18.3 to 80.0 micrograms/dL; women, 44.0 micrograms/dL; SD, 20.1; range, 11.2 to 74.2 micrograms/dL). Mean auditory thresholds at frequencies susceptible to ototoxicity (2.0, 3.0, 4.0, 6.0, and 8.0 kHz) revealed sensory-neural hearing loss in men, which may be attributable to occupational noise exposure in combination with Pb intoxication. Bilateral brainstem auditory evoked response tests on participants with elevated blood Pb levels (mean, 47.0 micrograms/dL) showed delayed wave latencies consistent with sensory-neural hearing impairment. The results suggest that environmental noise exposure must be considered an important factor in determining sensory-neural hearing status in occupationally Pb-exposed adults.- - - - - - - - - - ranking = 0.5keywords = intoxication (Clic here for more details about this article) |
5/74. Superior vena cava thrombosis in chronic lead exposure--a case report.Thrombosis is a rare cause of superior vena cava syndrome (SVCS). A 43-year-old male patient with SVCS due to thrombosis underwent investigation for the etiology of thrombus formation. He had been hospitalized several times because of lead intoxication in the past. Lead has a known thrombogenetic effect experimentally. This patient with superior vena cava thrombosis had thrombophilia that was probably due to lead intoxication. The etiologies of venous thrombosis and thrombogenetic effect of chronic lead exposure are discussed.- - - - - - - - - - ranking = 0.5keywords = intoxication (Clic here for more details about this article) |
6/74. Whole bowel irrigation in an acute oral lead intoxication.An 89-year-old man acutely ingested approximately three ounces of a ceramic glaze preparation with a 30% lead oxide content. A blood lead level of 18 micrograms/mL was reported from a sample drawn within 1 hour of ingestion and just prior to gastric lavage. Following lavage, an abdominal radiograph demonstrated lead throughout the small intestine. Whole bowel irrigation was then undertaken and subsequent x-rays demonstrated clearing of all lead in the small bowel. At 16 and 24 hours post-ingestion, blood lead levels rose to 39 micrograms/dL and 42 micrograms/dL, respectively, and the patient then underwent a 5-day course of chelation therapy. This is the first reported case of the use of whole bowel irrigation in an acute lead ingestion. The use of decontamination techniques in acute lead ingestions is reviewed.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
7/74. pica-associated cerebral edema in an adult.Acute cerebral edema due to lead intoxication is an unusual presentation in an adult. Here we describe an adult with pica presenting with severe encephalopathy due to extremely high lead levels (>200 microg/dl) with marked cerebral edema and mild hyperammonemia. Rapid initiation of chelation therapy led to a reduction in serum lead and ammonia levels and a resolution of the cerebral edema and encephalopathy, suggesting a close relationship between lead toxicity and hepatic dysfunction.- - - - - - - - - - ranking = 0.25keywords = intoxication (Clic here for more details about this article) |
8/74. The interpretation of zinc protoporphyrin changes in lead intoxication: a case report and review of the literature.BACKGROUND: zinc protoporphyrin (ZPP) has been used both as a screening and diagnostic test for overexposure to lead for nearly 30 years, although limitations for both purposes are recognized. methods: We present longitudinal findings for ZPP and whole-blood lead in a man with two episodes of acute lead intoxication and review the literature on the use of ZPP. RESULTS AND CONCLUSIONS: ZPP elevations in both chronic and acute exposure settings lag behind elevations in whole-blood lead by approximately 8-12 weeks. Therefore, ZPP measurement, in conjunction with whole-blood lead determination, has clinical utility in cases of substantial overexposure by providing information on how long an individual may have been overexposed to lead. A guide to the interpretation of various combinations of whole-blood lead and ZPP results is provided. However, while ZPP levels do correlate with whole-blood lead measurements in aggregate, the considerable individual variability of ZPP measurements, poor sensitivity at lower ranges of lead exposure, poor specificity and delayed changes in unstable exposure conditions indicate that this test contributes little to screening programs. Finally, our results confirm that basophilic stippling is seen in acute as well as chronic lead intoxication, and may provide the first indication of lead intoxication.- - - - - - - - - - ranking = 1.75keywords = intoxication (Clic here for more details about this article) |
9/74. Neuropsychologic and postural sway improvement after Ca( )-EDTA chelation for mild lead intoxication.Neuropsychologic and postural sway test performance improved following Ca( )-EDTA chelation in a bridge worker with persistent central nervous system (CNS) symptoms 2 years after an episode of subacute lead intoxication. This case highlights the value of these tests in verifying symptoms and documenting response to therapy. Persistent disabling CNS symptoms with objective neuropsychologic deficits was unexpected, given the borderline total body lead burden.- - - - - - - - - - ranking = 1.25keywords = intoxication (Clic here for more details about this article) |
10/74. Plumbism or lead intoxication mimicking an abdominal tumor.The clinical presentation of lead intoxication may vary widely and in the absence of a high clinical index of suspicion, the diagnosis may be missed. The effects of lead on mitochondrial oxidative phosphorylation and its interaction with calcium-mediated processes explain the heterogenous presentation. In this case report, the diagnosis was finally made when bilateral wrist drop developed on top of abdominal cramps and anemia. Before, ascites raised the suspicion of a tumor. Therefore, each element of the triad of unexplained anemia, abdominal cramps, and bilateral wrist (or foot) drop should lead any physician to consider the diagnosis of lead intoxication. This case also illustrates the importance of a careful and meticulous social history in patient management.- - - - - - - - - - ranking = 1.5keywords = intoxication (Clic here for more details about this article) |
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