Lead poisoning following ingestion of pieces of lead roofing plates: pica-like behavior in an adult

Clin Toxicol (Phila). 2008 Mar;46(3):267-9. doi: 10.1080/15563650701639014.

Abstract

A 37-year-old man was admitted to hospital after complaining of abdominal pain for the past two weeks. On admission the abdominal radiograph showed multiple radio-opaque flecks dispersed throughout the gastrointestinal tract. Blood testing showed hemoglobin level 8.7 g/dL and a blood lead level of 112.4 microg/dL. The family interview revealed that the patient had pica-like behavior since childhood. He was a site foreman and had been ingesting pieces of roofing plates for a few weeks. The patient was treated with laxatives and CaNa(2)EDTA therapy was initiated. The blood lead level then dropped to 69.9 microg/dL. The patient received two subsequent courses of oral succimer and the blood lead level decreased to 59 microg/dL 21 days after the first course. The follow-up abdominal X-ray 20 days after the first examination was normal. Four months later, an outpatient follow-up visit showed a blood lead level within normal limits (14.5 microg/dL) and a psychiatric follow-up was initiated. Lead poisoning following the ingestion of lead-containing foreign bodies is particularly rare in adults, while it is sometimes observed in children. Pica behavior is a well-identified risk factor of lead intoxication in children but is quite exceptional in adults, where it is usually considered to be a psychiatric condition. Other unusual sources of lead poisoning include the ingestion of lead bullets, ceramic lead glaze or glazed earthenware, lead-contaminated candies, ethnic or herbal remedies.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / chemically induced
  • Abdominal Pain / diagnosis
  • Abdominal Pain / diagnostic imaging
  • Adult
  • Bone Diseases / complications
  • Bone Diseases / pathology
  • Chelating Agents / therapeutic use
  • Edetic Acid / therapeutic use
  • Electromyography
  • Humans
  • Laxatives / therapeutic use
  • Lead / blood
  • Lead Poisoning / diagnostic imaging
  • Lead Poisoning / drug therapy
  • Lead Poisoning / etiology*
  • Leukemia / complications
  • Leukemia / pathology
  • Male
  • Neuropsychological Tests
  • Pica / complications*
  • Pica / psychology
  • Radiography

Substances

  • Chelating Agents
  • Laxatives
  • Lead
  • Edetic Acid