LEAD POISONING

: Done by
Wadeah AL-abdullatif 232040040
 The case
Falah Ali is a 55-years old worker came to outpatient
clinic complaining of persistent headache and weakness.
He has lost about 20 kg of weight in the last 12 months.
He has no appetite and his gums are painful.
Occasionally, he gets severe abdominal colic. He is also
complaining of weakness of his right hand. For his living,
he has been making Arabic coffee pots for the last 30
years.

On examination, he looks pale, abdomen is distended,

gums are inflamed and there is grey line over his gingiva.
Laboratory investigations:
Hb 7mg/dl hypochromic microcytic
anemia with 100 stippled cells per
100,000 erythrocytes.
Blood lead levels were 100 mcg
(normal < 10 mcg/dl).
All other investigations were within
normal limits.
 Problem List

History :
Persistent headache and weakness
Weight loss of about 20 kg in the last 12
months.
Loss of appetite
His gums are painful.
Severe abdominal colic.
Weakness of his right hand.
Arabic coffee pots for the last 30 years.
Physical Examination:
pale, abdomen is distended.
gums are inflamed and there is grey line over his
gingiva.

Investigations:
Hb 7mg/dl hypochromic microcytic anemia.
Blood lead levels were 100 mcg (Less than 10 )

Dx: chroinc lead poisoning

 Pathophysiology

Multisystem toxicity of lead is mediated by

 Binds to sulfhydryl group (SH) lead to decrease enzyme activity.

 Interferes with action of ions: e.g. Ca++ ,Fe ++ , Zn ++

 Alter the structure of cell membrane and receptors.

Forms of lead poisoning:

 Inorganic lead poisoning
 Organic lead poisoning
 Therapeutic objectives

• Immediate Termination of exposure.

• Supportive care.

• Removal of lead from the body.

Treat anemia.
After finish treat lead poising treat anemia by
iron ,folic acid and Vit B12
 Chelating Agents
Total Cost Suitability Safety Efficacy

9 + ++ ++ ++++ Dimercaprol
(IM) (BAL)
15 +++ ++++ ++++ ++++ Succimer
(Oral) (DMSA)
13 ++ ++++ +++ ++++ )DMPS(
(IV) Unithiol
14 ++++ +++ +++ ++++ EDTA
(IV,IM)
10 +++ +++ ++ ++ Penicillamine
(oral)
9 +++ +++ +++ 0 Defroxamine
 Prescription
 Patient’s name: Falah Ali Sex: M Age: 55 years
 Date:
MR: *****
 Dx: Chronic lead poisoning
 Rx:
Succimer  10 mg/kg/d PO tid for 5 d

or
Succimer10 mg/kg/d PO bid for 14 d

 Doctor’s Name: Signature:

 Follow Up and Prevention

Ask the patient to return after 5 days

Ask the patient to return after finishing the
treatment
Patient education:
 should use appropriate personal protective
equipment
 change his clothing and shoes before going
home
 shower before going to bed.
Prevention in general:
Lead poisoning may be prevented or limited
by removing the source of lead in your home
or workplace and by eating a healthful,
balances diet.

Prevention anemia:
by eating healthful and take iron tablet
Thank you