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A Case of Lead Poisoning After Ingestion of Herb Pills
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Se Won Oh, Hyung Jai Lee, Hong Jae Chae, Sung Kwan Lee, Jai Dong Moon, Deok Cho
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Korean Journal of Occupational and Environmental Medicine 2007;19(3):231-237. Published online September 30, 2007
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DOI: https://doi.org/10.35371/kjoem.2007.19.3.231
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 Abstract
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- BACKGROUND
Lead is a common environmental metal and has been used for various purposes for a long time, leading to frequent reports of lead poisoning. The concern about lead poisoning starts has been mostly focused on occupational exposure and is linked to the prevention and management of lead exposure in refining and manufacturing processes. Nowadays, however, there is growing concern about nonoccupational lead exposure by many pollutants. Especially, lead poisoning by herb medicine has commonly been observed in clinics in Southeast Asia and South Korea. This case report contains diagnosis of inpatients who suffered from lead poisoning from a herb medicine, arthritis remedy and who complained of abdominal symptoms and dizziness. The study purpose was to awaken our healthful interest in lead poisoning.
CASE
REPORT: A 53-year-old female patient complaining of abdominal pain, dizziness, and numbness of hand and foot came to our hospital due to the continuation of her anemic finding symptoms while undergoing treatment at a secondary hospital. Her past medical history was unremarkable except she had taken herb pills for about a year which were administered by herb medicine to treat arthritis. Physical examination was unremarkable except for oral ulcer finding. Hemoglobin was 8.5 g/dl, reticulocyte count was 4.10%, bilirubin was 1.3 mg/dl (direct 0.3 mg/dl), and Zinc protoporphyrin 169.12 ug/dl. In urinalysis results, WBC increased to 30~39 /HPF, While AST/ALT, BUN/Cr, PT/aPTT, and nerve conduction velocity were normal. Basophilic stippling was observed through peripheral blood smear. The blood lead level was 80.4 microgram/dl and the urine lead level continued to increase to 541 microgram/l. Analysis of the pills that the patient had been taking showed that they contained 30 mg/g lead. By oral chelation therapy with D-penicillamine four times per day for five days, the patient's hemoglobin increased to 11.8 g/dl, while blood lead level decreased to 39.2 microgram/dl, and urine level to 196 microgram/l. Although the soles of her feet remained cold, but other symptoms and anemia finding were improved considerably. However, after discontinuing D-penicillamine medication, the blood lead level increased to 41.4 microgram/dl again. The further administration of D-penicillamine for five days reduced the blood lead level to 31.5 microgram/dl. At two years after the discontinuance of D-penicillamine, the followup findings were normal; hemoglobin was 13.1 g/dl, hematocrit 39.6%, reticulocyte count 1.22%, blood lead level 13.3 microgram/dl, and urine lead level 9.17 microgram/l.
CONCLUSION
After taking herb medicine pills for one year, the patient was admitted to hospital chiefly complaining of abdominal pain, dizziness, and numbness of the hand and foot. The high blood and urine and lead levels and lead chemical analysis of the herb pills confirmed lead poisoning which was treated with D-penicillamine for five days. The follow-up result after two years indicated normal blood and urine lead levels.
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Citations
Citations to this article as recorded by  - Sources, distribution, bioavailability, toxicity, and risk assessment of heavy metal(loid)s in complementary medicines
Shiv Bolan, Anitha Kunhikrishnan, Balaji Seshadri, Girish Choppala, Ravi Naidu, Nanthi S. Bolan, Yong Sik Ok, Ming Zhang, Chun-Guang Li, Feng Li, Barry Noller, Mary Beth Kirkham
Environment International.2017; 108: 103. CrossRef - A Case of Lead Poisoning with Drug-induced Liver Injury after Ingestion of Herbal Medicine
Gi Jung Jeon, Jongha Park, Min Sung Kim, Jong Won Yu, Jae Hyun Park, Min Sik Kim
The Korean Journal of Gastroenterology.2015; 65(6): 375. CrossRef - Adverse Events Associated with Metal Contamination of Traditional Chinese Medicines in Korea: A Clinical Review
Hyunah Kim, Peter J. Hughes, Emily M. Hawes
Yonsei Medical Journal.2014; 55(5): 1177. CrossRef
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Subcutaneous and Gastrointestinal Exposure to Metallic Mercury: Report of 2 Cases
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Sung Kwan Lee, Hyoung Jai Lee, Hong Jae Chae, Jai Dong Moon
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Korean Journal of Occupational and Environmental Medicine 2003;15(4):446-451. Published online December 31, 2003
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DOI: https://doi.org/10.35371/kjoem.2003.15.4.446
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Abstract
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- BACKGROUND
Mercury poisoning presents a variety of clinical pictures depending on the chemical structure, the route of exposure, the amount absorbed and other individual factors. Therefore, the ingestive and subcutaneous absorption of elemental(metallic) mercury can be considered to be relatively harmless in contrast to the inhalation of mercury vapor.
CASE REPORTS
A 72-year-old man presented to the department of urology due to tenderness, edema and a necrotic abscess of his penis after trauma. The soft tissue abscess required a surgical resection of the penis. For chelation therapy, oral D-penicillamine was administrated. 7 months later, he showed no subjective or objective signs of mercury poisoning. Another 5-yearold girl presented to the emergency department after accidental self-ingestion of elemental mercury. She was followed clinically and did not show any systemic mercury poisoning.
CONCLUSION
The Mercury concentrations in the blood and urine were elevated in the case of subcutaneous exposure, but was unchanged in the case of ingestion. Subcutaneous and gastrointestinal exposure to metallic mercury has a minimal risk for systemic mercury poisoning, which is in contrast to the exposure by inhalation.
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A study on the knowledge and attitude of workers at health hazardous workplace in occupational health
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Sung Kwan Lee, Mi Young Lee, Nung Ki Yoon, Seoung Hoon Lee
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Korean Journal of Occupational and Environmental Medicine 1992;4(2):162-180. Published online October 31, 1992
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DOI: https://doi.org/10.35371/kjoem.1992.4.2.162
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Abstract
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- No abstract available.
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Byssinosis in carbon textile workers in Taegu, Korea
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Doohie Kim, Soon Woo Park, Hong Hwan Kim, Kyeong Dong Chung, Duk Hee Lee, Sung Kwan Lee
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Korean Journal of Occupational and Environmental Medicine 1991;3(2):177-184. Published online November 30, 1991
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DOI: https://doi.org/10.35371/kjoem.1991.3.2.177
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Abstract
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- No abstract available.
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