QUESTION: How can I determine if my patient is lead poisoned? 08/04/11 New South Wales, Australia
I have a 33yr old friend and patient who presents with chronic abdominal cramping, bloating, and non-specific bowel changes. He has seen many specialists and had extensive investigation. A Chinese physician, thought that his presentation was not dissimilar to those patients that he had seen in China with clinical lead poisoning.
I have attempted to find out what the typical abdominal presentation of lead poisoning in an adult might be. Unfortunately, the literature on the subject is sparse. I, and he, would be most grateful if you are able to assist.
EMAIL TWO: Tuesday, April 12, 2011 11:32 AM
Thank you for your detailed email which I have forwarded to the patient.
It is a great asset to have someone of your calibre to assist in helping patients to exclude lead as a cause of their ongoing and debilitating problems. The resources on the website also offer detailed and practical treatment options. I wish that there was a local mercury website when I was looking to solutions to my mercury poisoning. That said, Phil Colquitt from BNE was a great support initially.
May you and yours be blessed.
ANSWER: Apr 9 2011
the variation in clinical presentation of lead poisoning is so great (eg lead can cause diarrhoea OR constipation) that it is not worthwhile to even look for symptoms, ask instead about likely exposure. However, having noted the symptoms you have noted, the absolute vital next test would be a whole blood lead estimate. The patient should also be questioned about his likely exposure to lead, not only currently but in the past. For this purpose, I have modified a US questionnaire, at Medical Evaluation Questionnaire for Occupational Lead Exposure
It would be useful for your interpretation of the blood lead level, to also read Dangers of a blood lead level above 2 μg/dL and below 10 μg/dL to adults
I'm very happy to comment further, as you find out more about the case.
All the best
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