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.
Dedeken
Peter
P
Department of Neurology, University Hospital Gasthuisberg, Leuven, Belgium.
Louw
Vernon
V
Vandooren
Ann-Karolien
AK
Verstegen
Geert
G
Goossens
Willy
W
Dubois
Bénédicte
B
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
D002614:Chelating Agents; D011524:Protoporphyrins; D004113:Succimer