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BMC Gastroenterology Oct 2020Chronic lead poisoning (CLP) is a rare cause of abdominal pain and is common in young children, in whom the incidence is higher than it is in adults. As the symptoms of... (Review)
Review
BACKGROUND
Chronic lead poisoning (CLP) is a rare cause of abdominal pain and is common in young children, in whom the incidence is higher than it is in adults. As the symptoms of CLP are nonspecific, misdiagnoses or missed diagnoses often occur, especially in sporadic cases.
CASE PRESENTATION
We report a 28-year-old young man who was misdiagnosed with renal colic due to sudden acute abdominal pain. After a detailed medical history and physical examination, other possible causes were excluded, CLP was finally diagnosed, and he recovered after chelation treatment.
CONCLUSION
Abdominal pain is a very common clinical symptom in adults, which has many causes. We should be vigilant against chronic poisoning, especially CLP. Detailed diagnosis and physical examination are crucial in early diagnosis and treatment.
Topics: Abdominal Pain; Adult; Anemia; Chelating Agents; Child; Child, Preschool; Chronic Disease; Humans; Lead Poisoning; Male
PubMed: 33054779
DOI: 10.1186/s12876-020-01482-x -
The Western Journal of Medicine Sep 1985
Topics: Child; Humans; Lead Poisoning; Paint; United States
PubMed: 4049856
DOI: No ID Found -
Environmental Health Perspectives Apr 1994Many countries, including Mexico, are facing a largely unrecognized epidemic of low-level lead poisoning. Mexico is the sixth largest lead-producing country in the... (Review)
Review
Many countries, including Mexico, are facing a largely unrecognized epidemic of low-level lead poisoning. Mexico is the sixth largest lead-producing country in the world, and 40% of its production is used locally in different industrial processes that cause lead contamination of the environment. The major sources and pathways of lead exposure among the Mexican population are gasoline emissions, lead-glazed ceramics, leaded paint, and lead in canned foods and beverages. In this paper we present evidence for the presence of lead in different environmental media and its impact on blood lead levels of the Mexican population. Although during the last few years important measures have been implemented to decrease lead exposure, our findings suggest that lead poisoning is still an important problem in Mexico. There is an urgent need for regulatory policies that implement stricter control to protect the Mexican population. There is also a need to develop adequate programs to reduce the lead burden and the associated health effects in the population that has been chronically exposed.
Topics: Ceramics; Chronic Disease; Environmental Exposure; Environmental Monitoring; Epidemiological Monitoring; Food-Processing Industry; Health Policy; Humans; Lead Poisoning; Mexico; Paint; Population Surveillance; Risk Factors; Urban Population; Vehicle Emissions
PubMed: 7523102
DOI: 10.1289/ehp.94102384 -
Frontiers in Public Health 2023Lead is a toxic element of the environment that leads to major complications once it enters the blood stream, affecting multiple organs and systems of the body.
BACKGROUND
Lead is a toxic element of the environment that leads to major complications once it enters the blood stream, affecting multiple organs and systems of the body.
METHODS
We present a case of a 6-month-old female infant diagnosed with lead poisoning after presenting for routine child health care. The child's mother denied that the infant had a history of exposure to lead-containing substances. After a month of calcium supplementation, the patient's blood lead level remained elevated. We then tested the blood lead level of the mother and father. The results showed that the blood lead level of the mother was 77.0 μg/L and that of the father was 36.9 μg/L. The high blood lead level of the mother attracted our attention. We found that the mother had been using an external traditional Chinese medicine, Hu Wang Fen, which contains lead. After the mother's discontinuation of use of the traditional medicine, the child was treated with symptomatic treatment and chelation therapy. Subsequently, the patient's blood lead level decreased significantly.
RESULTS
Lead toxicity can be a life-threatening problem because of its potential for severe complications. In children, there is no safe blood lead level, and the toxic effects of lead can be prevented by the awareness and avoidance of traditional Chinese medicines that may contain lead.
CONCLUSION
Even though the diagnosis of lead poisoning remains difficult in children, it must be taken into consideration by the clinician when treating a child using traditional Chinese medicines.
Topics: Child; Humans; Infant; Female; Lead; Lead Poisoning; Medicine, Chinese Traditional; Mothers
PubMed: 37213598
DOI: 10.3389/fpubh.2023.1132199 -
Turkish Journal of Haematology :... Nov 2018
Topics: Aged; Basophils; Chelating Agents; Chelation Therapy; Female; Humans; Lead Poisoning
PubMed: 30182925
DOI: 10.4274/tjh.2018.0195 -
The Israel Medical Association Journal... Nov 2009More than 90% of body lead is stored in bone. The technique of K-X-Ray fluorescence developed in the 1990s has enabled the quantitative measurement of decades of... (Review)
Review
More than 90% of body lead is stored in bone. The technique of K-X-Ray fluorescence developed in the 1990s has enabled the quantitative measurement of decades of cumulative lead in bone, whereas blood lead levels reflect only recent exposure to lead. Bone lead is mobilized into the blood like bone calcium, as in osteoporosis, and exposes the patient to increased lead load. Many studies have assessed the toxic effect of chronic exposure from childhood to old age in present or former workers in industrial lead, as well as in non-occupational citizens in whom social and environmental circumstances might have induced higher exposure levels. This review points to the effects of elevated levels of bone lead and the associated cognitive decline among the elderly, with lead toxicity being one of the possible causes of degenerative dementia. There is evidence of an association between increased bone lead levels and renal disease, degenerative diseases like cataract, and suggestive but not causal association with blood pressure and hypertension. Community surveys show increased mortality associated with exposure to lead. Removal of sources of lead exposure, for example the use of non-leaded petrol, has reduced lead levels in the population, and there are currently strong recommendations to further lower the present allowed blood lead level to minimize chronic cumulative lead toxicity.
Topics: Aged; Bone and Bones; Cognition Disorders; Environmental Exposure; Humans; Lead; Lead Poisoning
PubMed: 20108558
DOI: No ID Found -
La Medicina Del Lavoro Apr 2021We report a case of a 30 years old Indian sailor with microcytic anemia (Hb 9.9), persistent abdominal pain, emesis, dark stool, hyperchromic urine, latent jaundice and...
PURPOSE
We report a case of a 30 years old Indian sailor with microcytic anemia (Hb 9.9), persistent abdominal pain, emesis, dark stool, hyperchromic urine, latent jaundice and asthenia. Lead intoxication was confirmed (blood lead value of 102 μg/dL). The patient assumed Ayurvedic medicines in the previous months. Ayurveda is an ancient form of Indian traditional popular medicine aiming to re-establish health and body function through herbal preparations, heavy metals are often added. Our purpose was to treat the patient and to establish the source of poisoning.
METHODS
After testing blood and urine lead concentration of other 3 crew members and analyzing over than 150 products used on the ship professional exposure was excluded. We analyzed the two Ayurvedic drugs assumed by the patient with an Inductively Coupled Plasma Mass Spectrometry. The patient underwent three chelation cycles with Calcium Disodium Ethylenediaminetetraacetic acid (EDTA) while monitoring blood and urinary lead levels.
RESULTS
The final blood lead level at discharge, after three chelation cycles, was 36.27 μg/dL. One of the two drugs contained extremely high concentrations of lead and mercury. The three different mixtures of this preparation showed lead concentrations of 12,638.54 mg/kg (Sample 2A), 23,043.02 mg/kg (Sample 2B), 21,352.97 mg/kg (Sample 2C); these levels are much higher than the highest values reported in literature for the indian soil (32 mg/kg).
CONCLUSIONS
This case and similar cases raise the safety alert on complementary and alternative medicines; Ayurvedic medicine users should be carefully informed about potential risks and signs of poisoning.
Topics: Adult; Humans; Lead; Lead Poisoning; Medicine, Ayurvedic; Mercury; Plant Preparations
PubMed: 33881010
DOI: 10.23749/mdl.v112i2.10576 -
The American Journal of Case Reports Jun 2023BACKGROUND Lead toxicity is a rare yet serious condition which can be difficult to diagnose due to vague presenting symptoms. Other pathologies can also mimic the...
BACKGROUND Lead toxicity is a rare yet serious condition which can be difficult to diagnose due to vague presenting symptoms. Other pathologies can also mimic the symptoms of chronic lead toxicity, making an already difficult diagnosis more challenging. There are multiple environmental and occupational contributors to lead toxicity. A thorough history and an open differential is the key to diagnosing and treating this rare disease. With increasing diversity of our patient population, we should keep an open differential, as the epidemiological features of presenting concerns have diversified as well. CASE REPORT A 47-year-old woman presented with persistent nonspecific abdominal pain despite extensive prior work, surgeries and a prior diagnosis of porphyria. This patient was eventually diagnosed as having lead toxicity when her most recent work-up for abdominal pain revealed no urine porphobilinogen and a high lead level. The cause of lead toxicity was attributed to be an eye cosmetic called "Surma", which can have variable lead levels. Chelation therapy was advised for the patient. CONCLUSIONS It is important to recognize the difficulty in this challenging diagnosis for nonspecific abdominal pain and to eliminate the mimickers. This case is interesting because the patient was initially diagnosed with porphyria, highlighting how heavy metals, lead in this case, can lead to a false-positive diagnosis of porphyria. Accurate diagnosis requires awareness of the role of urine porphobilinogen, checking lead levels, and an open differential. This case also emphasizes the importance of avoiding anchor bias to make a timely diagnosis of lead toxicity.
Topics: Female; Humans; Middle Aged; Lead; Porphobilinogen; Abdominal Pain; Lead Poisoning
PubMed: 37291827
DOI: 10.12659/AJCR.939504 -
Journal of Primary Care & Community... 2021Despite declining lead exposure among U.S. children, childhood blood lead level (BLL) undertesting and elevation remains a public health issue. This study explores the...
BACKGROUND
Despite declining lead exposure among U.S. children, childhood blood lead level (BLL) undertesting and elevation remains a public health issue. This study explores the impacts of maternal, infant, and neighborhood characteristics on the receipt of lead testing and having elevated BLLs (EBLLs) among children under age two.
METHODS
Pennsylvania infants born in 2015 and 2016 were followed to 24 months. Birth certificate data were linked to 2015 through 2018 blood lead surveillance data and neighborhood data on household income, poverty, and the burden of houses built before 1970. Generalized linear mixed models were used to examine the individual and neighborhood characteristics independently and/or interactively affecting the likelihood of lead testing and of having EBLLs.
RESULTS
A total of 48.6% of children were tested for BLLs, and 2.6% of them had confirmed EBLLs. The likelihood of lead testing and of having EBLLs among non-Hispanic black children was respectively 7% and 18% higher than white children. Children born to mothers with the lowest educational attainment (
CONCLUSION
This cohort analysis provides more accurate estimates of lead screening rates and the percentages of EBLLs than cross-sectional analysis. Some maternal and infant demographics significantly impact the risk of undertesting and of having EBLLs, and some of the effects vary across different neighborhood characteristics. These findings can help lead prevention programs to target screening and treatment resources to children with specific characteristics.
Topics: Child; Cohort Studies; Cross-Sectional Studies; Humans; Infant; Lead; Lead Poisoning; Pennsylvania; Residence Characteristics
PubMed: 34009062
DOI: 10.1177/21501327211017780 -
BMC Public Health Jul 2021Ingestion and inhalation are common routes of exposure for lead in humans. Developing countries still have unacceptably high rates of lead toxicity, especially in...
BACKGROUND
Ingestion and inhalation are common routes of exposure for lead in humans. Developing countries still have unacceptably high rates of lead toxicity, especially in children. Studies on probable risk factors of lead poisoning in Iranian children are insufficient. In this study, we aimed to evaluate possible environmental factors in children with high blood lead concentrations living in Tehran and neighboring cities.
METHODS
In a prospective cross-sectional study between March 2018 and March 2019 we followed all children referred from two pediatric gastrointestinal clinics with blood lead level (BLL) > 5 μg/dL in metropolitan Tehran to investigate possible environmental risk factors in their home. Household specimens including scratched wall paint, house floor dust, windowsill dust, tap water, and consumed spice were evaluated using atomic absorption method to detect lead concentrations. Epidemiological and environmental data collected through in-depth interviews with parents/guardians. Industrial areas were defined based on municipality maps on industrial places.
RESULTS
Thirty of 56 parents/guardians with BLL > 5 μg/dL agreed to be followed through environmental investigation. The only categorical statistically significant risk factor was a history of lead poisoning in the family and living in an industrial zone. There was a positive correlation between BLL and interior windowsills dust lead level, r = 0.46, p = 0.01. Scratched paint lead level and BLL showed a significant positive correlation, r = 0.50, p = 0.005. House floor dust lead level (median = 77.4, p < 0.001) and interior windowsill dust lead level (median = 291, p = 0.011) were both significantly higher than the environmental protection agency (EPA) standards of 40 μg/ft, 250 μg/ft. Interior windowsill dust lead concentrations were significantly higher in industrial areas (p = 0.026).
CONCLUSION
Children's playing environment should be cleaned more often to reduce dust. Moreover, specific rules may need to be implemented for paint lead concentrations and air pollution, especially in industrial areas.
Topics: Child; Cities; Cross-Sectional Studies; Dust; Environmental Exposure; Humans; Iran; Lead; Lead Poisoning; Prospective Studies
PubMed: 34289825
DOI: 10.1186/s12889-021-11494-1