title: Lead nephropathy due to Sindoor in India.
abstract: We report a case of lead nephropathy due to Sindoor treated successfully with steroid, hemodialysis and chelating agent. Diagnosis of lead nephropathy was confirmed by identification of potential sources of lead exposure (Sindoor, 5-10 gm per year for 11 years) indicated by high blood lead level, 95 µg/dL and presence of extrarenal features of lead poisoning (hypertension, anemia, lead line, hyperuricemia). A search for the underlying systemic causes of renal failure yielded no results. A kidney biopsy showed acute or chronic tubule-interstitial nephritis with mesangioproliferative glomerulonephritis with no immune deposit on immunofluorescence consistent with lead nephropathy. He was discharged in good health after psychiatric consultation and continued with oral D-Penicillamine with normal renal function tests and urine output. This case identifies Sindoor as a potential lead exposure among Indians and clinicians should be aware of this risk factor and enquire about it when searching a source of lead exposure in high-risk population.
authors.affiliation: Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences [IKDRC-ITS], Ahmedabad, India. drvivekkute@rediffmail.com
authors.forename: Vivek B
authors.initials: VB
authors.lastname: Kute
authors.forename: Jigar D
authors.initials: JD
authors.lastname: shrimali
authors.forename: Manish R
authors.initials: MR
authors.lastname: Balwani
authors.forename: Umesh R
authors.initials: UR
authors.lastname: Godhani
authors.forename: Aruna V
authors.initials: AV
authors.lastname: Vanikar
authors.forename: Pankaj R
authors.initials: PR
authors.lastname: Shah
authors.forename: Manoj R
authors.initials: MR
authors.lastname: Gumber
authors.forename: Himanshu V
authors.initials: HV
authors.lastname: Patel
authors.forename: Hargovind L
authors.initials: HL
authors.lastname: Trivedi
mesh_terms: D000328:Adult; D006801:Humans; D007194:India; D007854:Lead / Q000009:adverse effects*; D008297:Male; D009393:Nephritis / Q000139:chemically induced*
chemical_list: D007854:Lead