Lomelí-Legaspi E, Lozano EA, Martínez-Coronel J

Language: Spanish
References: 15
Page: 1290-1295
PDF size: 304.93 Kb.

ABSTRACT

Background: Lead poisoning has a very varied clinical presentation, which in many cases complicates the diagnosis; the severity of it depends on the time and amount of exposure, this exposure is usually occupational, especially those activities related to mining, metallurgy, water or contaminated food and, on rare occasions, it is secondary to contact with retained bullets in the body.
Clinical case: A 34-year-old male patient, who 10 years earlier suffered gunshot wounds in four body regions, which caused the retention of shards that in turn caused lead poisoning.
Conclusions: Diagnosis is made with an adequate medical history, identifying the source of contact and confirming it by measuring lead levels in blood, treatment is based on reducing the degree of exposure or, if required, chelation therapy.

REFERENCES

1. United States Agency for Toxic Substances and DiseaseRegistry (ATSDR). Medical Management Guidelines forLead (Pb). ATSDR 2014 Oct PDF.

2. Papanikolaou N, Hatzidaki E, Belivanis S, Tzanakakis G,Tsatsakis A. Lead toxicity update. A brief review. Med SciMonit 2005; 11 (10): RA329-36.

3. Riva M, Lafranconi A, D’Orso M, Cesana G. Lead poisoning:historical aspects of a paradigmatic “occupational andenvironmental disease”. Saf Health Work 2012; 3: 11-6.doi: 10.5491/SHAW.2012.3.1.11.

4. Public Health and Environment World Health Organization.Preventing disease through healthy environments, exposureto lead: A major public health concern. 20 AvenueAppia, 1211 Geneva 27, Switzerland.

5. Apte A, Bradford K, Dente C, Smith RN. Lead toxicityfrom retained bullet fragments: A systematic review andmeta-analysis. J Trauma Acute Care Surg 2019; 87 (3). DOI:10.1097/TA.0000000000002287.

6. Charris V, Guerrero A, Barrera C. Intoxicación por plomosecundaria a alojamiento de esquirlas en el cuerpo.Acta Medica Colombiana 2011; 36 (4). DOI 10.36104/amc.2011.1450.

7. Centers for Disease Control and Prevention (CDC). Adultblood lead epidemiology and surveillance--United States,2008-2009. MMWR Morb Mortal Wkly Rep 2011; 60 (25):

8. 841-845.8. Centers for Disease Control and Prevention (CDC). Very highblood lead levels among adults - United States, 2002-2011[published correction appears in MMWR Morb Mortal WklyRep 2014; 383 (9912): e3 [published correction appearsin MMWR Morb Mortal Wkly Rep. 2014; 62 (51): 1053].MMWR Morb Mortal Wkly Rep. 2013;62(47):967-971.

9. Centers for Disease Control and Prevention (CDC). Bloodlead levels in residents of homes with elevated lead in tapwater--District of Columbia, 2004. MMWR Morb MortalWkly Rep 2004; 53 (12): 268-270.

10. Wedeen R, Goldman R, Headapohl D, Hipkins K, Hu H, etal. Association of Occupational and Environmental Clinics(AOEC). Medical Management Guidelines for Lead-ExposedAdults, Revised 04/24/2007. CSTE Medical ManagementGuidelines Added October 2013; 16-17.

11. United States Occupational Safety and Health Administration(OSHA). Lead standards for general industry andshipyard employment.

12. United States Centers for Disease Control and Prevention.4th national report on human exposure to environmentalchemicals. Feb 2015.

13. Kosnett MJ, Wedeen RP, Rothenberg SJ, Hipkins KL, MaternaBL, Schwartz BS, et al. Recommendations for medicalmanagement of adult lead exposure. Environ HealthPerspect 2007; 115 (3): 463-471. doi: 10.1289/ehp.9784.

14. Mudipalli A. Lead hepatotoxicity & potential health effects.Indian J Med Res 2007; 126 (6): 518-527.

15. Thomson RM, Parry GJ. Neuropathies associated withexcessive exposure to lead. Muscle Nerve 2006; 33 (6):732-741. doi:10.1002/mus.20510.