Lead poisoning following ingestion of pieces of lead roofing plates: pica-like behavior in an adult.
A 37-year-old man was admitted to hospital after complaining of abdominal pain for the past two weeks. On admission the abdominal radiograph showed multiple radio-opaque flecks dispersed throughout the gastrointestinal tract. Blood testing showed hemoglobin level 8.7 g/dL and a blood lead level of 112.4 microg/dL. The family interview revealed that the patient had pica-like behavior since childhood. He was a site foreman and had been ingesting pieces of roofing plates for a few weeks. The patient was treated with laxatives and CaNa(2)EDTA therapy was initiated. The blood lead level then dropped to 69.9 microg/dL. The patient received two subsequent courses of oral succimer and the blood lead level decreased to 59 microg/dL 21 days after the first course. The follow-up abdominal X-ray 20 days after the first examination was normal. Four months later, an outpatient follow-up visit showed a blood lead level within normal limits (14.5 microg/dL) and a psychiatric follow-up was initiated. Lead poisoning following the ingestion of lead-containing foreign bodies is particularly rare in adults, while it is sometimes observed in children. Pica behavior is a well-identified risk factor of lead intoxication in children but is quite exceptional in adults, where it is usually considered to be a psychiatric condition. Other unusual sources of lead poisoning include the ingestion of lead bullets, ceramic lead glaze or glazed earthenware, lead-contaminated candies, ethnic or herbal remedies.
Sabouraud
Sabine
S
Lyon Poison Center, Toxicovigilance Unit, Lyon, France. sabine.sabouraud@chu-lyon.fr
Testud
François
F
Descotes
Jacques
J
Benevent
Monique
M
Soglu
Gilbert
G
D015746:Abdominal Pain / Q000139:chemically induced / Q000175:diagnosis / Q000000981:diagnostic imaging; D000328:Adult; D001847:Bone Diseases / Q000150:complications / Q000473:pathology; D002614:Chelating Agents / Q000627:therapeutic use; D004492:Edetic Acid / Q000627:therapeutic use; D004576:Electromyography; D006801:Humans; D054368:Laxatives / Q000627:therapeutic use; D007854:Lead / Q000097:blood; D007855:Lead Poisoning / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D007938:Leukemia / Q000150:complications / Q000473:pathology; D008297:Male; D009483:Neuropsychological Tests; D010842:Pica / Q000150:complications* / Q000523:psychology; D011859:Radiography
D002614:Chelating Agents; D054368:Laxatives; D007854:Lead; D004492:Edetic Acid