We report a case of a 39-year-old art conservator who presented complaining of abdominal pain and constipation. His laboratory results showed normocytic normochromic anemia and abnormal liver tests. Computed tomography revealed distention of the whole colon without obstruction. Evaluation of anemia was compatible with nonimmune hemolysis. A liver biopsy showed accumulation of ferric pigment in Kupffer cells. Given the typical findings in the blood smear and the epidemiological context, a serum lead assay was performed (92 μg/dL). This clinical case illustrates the need for gastroenterologists to recognize digestive manifestations of systemic diseases, including intoxications.
© 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.