title: Unexpected presentations--four cases of lead poisoning.
abstract: OBJECTIVE
  To describe the clinical presentation and response to treatment of four patients who presented with abdominal pain and were diagnosed to have lead poisoning.
  
  
  METHODS
  After ruling out the more obvious causes of abdominal pain by barium studies, gastrointestinal endoscopies, and biochemical studies, blood lead levels were estimated by atomic absorption spectrophotometry. The patients were treated with oral d-penicillamine.
  
  
  RESULTS
  The four patients had blood lead levels from 79 microg/dL to 365 microg/dL. All four of them showed marked improvement in their clinical condition and lowering of blood lead levels on follow up.
  
  
  CONCLUSIONS
  Clinicians need to develop a high index of suspicion of lead poisoning as a possible cause of unexplained abdominal pain or altered sensorium, especially against a background of environmental lead contamination in India.
authors.affiliation: Department of Medicine, JIPMER, Pondicherry.
authors.forename: J
authors.initials: J
authors.lastname: Mathew
authors.forename: T
authors.initials: T
authors.lastname: Mathew
authors.forename: R
authors.initials: R
authors.lastname: Kannan
authors.forename: S
authors.initials: S
authors.lastname: Satheesh
authors.forename: T
authors.initials: T
authors.lastname: Sundararaman
authors.forename: K R
authors.initials: KR
authors.lastname: Sethuraman
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007855:Lead Poisoning / Q000150:complications*; D008297:Male; D008875:Middle Aged