title: Plumbism or lead intoxication mimicking an abdominal tumor.
abstract: 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.
authors.affiliation: Department of Neurology, University Hospital Gasthuisberg, Leuven, Belgium.
authors.forename: Peter
authors.initials: P
authors.lastname: Dedeken
authors.forename: Vernon
authors.initials: V
authors.lastname: Louw
authors.forename: Ann-Karolien
authors.initials: AK
authors.lastname: Vandooren
authors.forename: Geert
authors.initials: G
authors.lastname: Verstegen
authors.forename: Willy
authors.initials: W
authors.lastname: Goossens
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Dubois
mesh_terms: D000008:Abdominal Neoplasms / Q000175:diagnosis*; D002614:Chelating Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D035264:Flowers; D006686:Hobbies; D006801:Humans; D007855:Lead Poisoning / Q000175:diagnosis* / Q000188:drug therapy; D020263:Lead Poisoning, Nervous System / Q000175:diagnosis* / Q000188:drug therapy; D008875:Middle Aged; D011524:Protoporphyrins / Q000097:blood; D004113:Succimer / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D002614:Chelating Agents; D011524:Protoporphyrins; D004113:Succimer