title: Quadriparesis Caused by Lead Poisoning Nine Years After a Gunshot Wound With Retained Bullet Fragments: A Case Report.
abstract: Lead toxicity in adults is characterized by nonspecific symptoms of abdominal pain, vomiting, constipation, fatigue, and weight loss. We present a case of severe lead toxicity that developed subacutely, causing quadriparesis 9 years after a gunshot wound with retained bullet fragments. The onset of symptoms may have been related to the development of a pseudocyst. The long interval between the gunshot wound and the onset of symptoms contributed to a delay in suspecting that the retained bullet was a source of lead toxicity. The patient's symptoms gradually improved after chelation therapy, removal of the bullet fragment, and an extended program of acute inpatient rehabilitation.
  
  
  METHODS
  V.
authors.affiliation: MedStar Georgetown University Hospital, Washington, DC(∗).
authors.forename: Emma
authors.initials: E
authors.lastname: Nally
authors.affiliation: Department of Radiology, MedStar Washington Hospital Center, Washington, DC(†).
authors.forename: James
authors.initials: J
authors.lastname: Jelinek
authors.affiliation: Musculoskelal Rehabilitation Program and Inpatient Services, MedStar National Rehabilitation Hospital, 102 Irving Street, NW, Washington, DC 20010(‡). Electronic address: robert.d.bunning@medstar.net.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Bunning
mesh_terms: D000328:Adult; D015913:Chelation Therapy / Q000379:methods; D005269:Femur / Q000601:surgery; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000601:surgery*; D006801:Humans; D007855:Lead Poisoning / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D011782:Quadriplegia / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D035583:Rare Diseases; D012720:Severity of Illness Index; D013997:Time Factors; D014948:Wounds, Gunshot / Q000150:complications*