Lead toxicity, an uncommon cause of abdominal pain and anaemia – case report

Lead poisoning represents an uncommon, but clinically significant condition. Lead is the most significant toxin of heavy metals, the addition of it to paints, and gasoline have created an epidemic poisoning

The authors report on a case of a multitudinous occupational lead poisoning which was caused by protracted inhalation of lead containing dust by industrial alpinists. A 34 years old man was sent to our department because of recurrent abdominal pain. Case history revealed no chronic disease. He was a heavy smoker. His complaints started two weeks before his admission, consisting of crampy periumbilical pain, fatigue, loss of appetite and weight. At the begining he had diarrhoea, but at admission constipation. Acut abdomen was excluded, the patient was anaemic, moderate leucocytosis and mild, indirect hyperbilirubinaemia was found. FOB test, ultrasonography, and colonoscopy was negative, upper endoscopy revealed duodenitis, biopsy from the duodenum showed no sign of coeliakia. Extended history taking led to the suspition of lead toxicity by exposure to lead containing dust from the painted chimney of an iron furnace which was knocked down by a group of workers including our patient. Lead content of the blood/5,41µmol/l/confirmed the clinical suspition of poisoning and the patient was sent to a special toxicological department. As a result of our diagnosis 7 team mates were examined and 6 of them were found to be intoxicated. Chelating agent was given to all of them. Diagnosing lead toxicity can be difficult; a history of lead exposure is instrumental in the diagnostic process. If unrecognized or inappropriately treated, toxicity can result in significant morbidity and mortality. GI complaints with anemia predominate in adults, patients are often sent to gastroenterological units. Our aim is to draw attention to this uncommon condition by summarizing the clinical aspects of chronic lead toxicity.