Chronic lead poisoning in an Iranian opium smoker resident in London.
A 46-year-old man of Iranian origin presented with a 4-day history of colicky abdominal pain and absolute constipation on a background of several weeks of irritability and malaise. He had smoked 10 g of opium per week for a year and a half. On examination, he had diffuse abdominal tenderness and faecal loading. This was cleared, but the abdominal pain, nausea and vomiting persisted. He had extravascular haemolytic anaemia with punctate basophilic stippling on blood film. The patient's serum lead concentration was substantially elevated and he perhaps demonstrated Burton's line. The patient underwent chelation therapy and has recovered clinically and biochemically. Public health experts were notified and conducted an assessment of the risk to the patient and others; their lead exposure questionnaire was subsequently amended. This is an important case report of a UK resident describing lead toxicity secondary to the inhalation of opium.
Barnet Hospital, Royal Free London NHS Foundation Trust, London, UK.
Alex
A
Azizi
North East & North Central London Health Protection Team, Public Health England London Region, London, UK.
Katie
K
Ferguson
Barnet Hospital, Royal Free London NHS Foundation Trust, London, UK.
Sam
S
Dluzewski
Barnet Hospital, Royal Free London NHS Foundation Trust, London, UK.
Tajammul
T
Hussain
Barnet Hospital, Royal Free London NHS Foundation Trust, London, UK.
Martin
M
Klein
D002614:Chelating Agents / Q000627:therapeutic use; D015913:Chelation Therapy; D002908:Chronic Disease; D004340:Drug Contamination; D006801:Humans; D007855:Lead Poisoning / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000097:blood / Q000150:complications*; D009892:Opium / Q000009:adverse effects*
D002614:Chelating Agents; D009892:Opium