title: [Outbreak of lead poisoning associated with Ayurvedic medicine].
abstract: OBJECTIVE
  Lead poisoning is normally caused by repeated occupational inhalation of lead. However, lead may also be absorbed through the digestive route. Some alternative medical treatments, such as Ayurvedic medicine, can also contain lead and may result in poisoning.
  
  
  METHODS
  We collected cases of lead poisoning related to Ayurvedic treatments attended at the Hospital Clinic of Barcelona.
  
  
  RESULTS
  Two female patients, aged 45 and 57 years, respectively, who initiated Ayurvedic treatments which involved the ingestion of various medicaments, were included. The first patient presented with anemia and abdominal pain. The lead level was 74μg/dL and free erythrocyte protoporphyrin was 163μg/dL. She was treated with intravenous calcium disodium ethylenediaminetetraacetic acid (CaNa2EDTA) and later with oral dimercaptosuccinic acid (DMSA) with a good evolution. The second patient presented with abdominal pain and a Burton's line. The lead level was 52μg/dL and free erythrocyte protoporphyrin was 262μg/dL. She was treated with oral DMSA and evolved favorably. Lead concentrations in some of the tablets supplied to the patients reached 2,003 and 19,650μg/g of tablet.
  
  
  CONCLUSIONS
  Lead poisoning may result from treatments based on Ayurvedic medicine and may reach epidemic proportions. Health control of alternative medicines is necessary.
authors.affiliation: Servicio de Medicina Interna, Hospital Clínic, Barcelona, España.
authors.forename: Sara
authors.initials: S
authors.lastname: Fernández
authors.affiliation: Servicio de Medicina Interna, Hospital Clínic, Barcelona, España.
authors.forename: Gerónimo-Antonio
authors.initials: GA
authors.lastname: Pollio
authors.affiliation: Servicio de Medicina Interna, Hospital Clínic, Barcelona, España.
authors.forename: Verónica
authors.initials: V
authors.lastname: Domínguez
authors.affiliation: Sección de Toxicología Clínica, Hospital Clínic, Barcelona, España. Electronic address: SNOGUE@clinic.ub.es.
authors.forename: Santiago
authors.initials: S
authors.lastname: Nogué
authors.affiliation: Sección de Toxicología Analítica, Hospital Clínic, Barcelona, España.
authors.forename: Mercè
authors.initials: M
authors.lastname: Torra
authors.affiliation: Servicio de Medicina Interna, Hospital Clínic, Barcelona, España.
authors.forename: Francesc
authors.initials: F
authors.lastname: Cardellach
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000747:Anemia, Hypochromic / Q000209:etiology; D002062:Bursitis / Q000150:complications / Q000188:drug therapy; D015913:Chelation Therapy; D004492:Edetic Acid / Q000627:therapeutic use; D005260:Female; D005356:Fibromyalgia / Q000150:complications / Q000188:drug therapy; D006801:Humans; D020265:Lead Poisoning, Nervous System, Adult / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008515:Medicine, Ayurvedic; D008875:Middle Aged; D004113:Succimer / Q000627:therapeutic use; D017086:beta-Thalassemia / Q000150:complications
chemical_list: D004492:Edetic Acid; D004113:Succimer
keywords: Ayurvedic medicine; Intoxicación por plomo; Lead poisoning; Medicina ayurvédica; Saturnism; Saturnismo
vernacular_title: Brote de saturnismo asociado a un tratamiento basado en la medicina ayurvédica.