Fonte R, Agosti A, Scafa F, Candura SM
Anaemia and abdominal pain due to occupational lead poisoning. [Journal Article]
Haematologica 2007 Mar; 92(3 Suppl):ECR07.
We describe a 47-year-old patient with chronic anaemia with basophilic stippling of erythrocytes, recurrent abdominal colics, discoloration of gums, sensitive polyneuropathy to the four limbs, hyper- uricaemia, hepatosteatosis with raised transami- nases, and a long ignored history of lead exposure in a battery recycling plant. The diagnosis of poi- soning was confirmed by high lead levels in the blood and urine, decreased erythrocyte delta- aminolevulinic acid dehydratase (ALA-D), raised erythrocyte zinc protoporphyrin (ZP), and elevat- ed urinary excretion of porphyrins. Chelation with EDTA resulted in increased urinary lead excretion, gradual improvement of the clinical picture, and progressive normalization of lead biomarkers. The case highlights the importance of occupational anamnesis for the diagnosis of lead poisoning, an uncommon condition which may mimic a variety of internal and surgical diseases. Since antiquity, lead has been extensively mined, produced, and utilized in a variety of industrial settings, such as metallurgy, construction, production of plastics, ceramics, paints and pigments.1-3Lead and its com- pounds are systemic toxicants, and a wide range of adverse health effects (including haematological, gastrointestinal, neuropsychiatric, cardiovascular, renal, endocrine, and reproductive disorders) has been observed in exposed workers.1,4,5The general population (particularly children) may also be exposed to toxic lead levels due to air, soil, food and water contamination.1,4,6 Thanks to the improvement of workplace hygienic conditions, the pathological pictureof occupational lead poi- soning (plumbism, saturnism) has gradually become less serious, at least in the most industri- alized countries, and has progressively changed into aspecific, subclinical manifestations.1, 5, 7 We describe here an unusual case (nowadays) of anaemia and recurrent abdominal pain due to lead poisoning from batteryrecycling.
More from this journal |
