Plumbism or lead intoxication mimicking an abdominal tumor

  • Peter Dedeken
  • Vernon Louw
  • Ann-Karolien Vandooren
  • Geert Verstegen
  • Willy Goossens
  • Bénédicte Dubois
Case Report

DOI: 10.1111/j.1525-1497.2006.00328.x

Cite this article as:
Dedeken, P., Louw, V., Vandooren, AK. et al. J Gen Intern Med (2006) 21: C1. doi:10.1111/j.1525-1497.2006.00328.x

Abstract

The clinical presentation of lead intoxication may vary widely and in the absence of a high clinical index of suspicion, the diagnosis may be missed. The effects of lead on mitochondrial oxidative phosphorylation and its interaction with calcium-mediated processes explain the heterogenous presentation. In this case report, the diagnosis was finally made when bilateral wrist drop developed on top of abdominal cramps and anemia. Before, ascites raised the suspicion of a tumor. Therefore, each element of the triad of unexplained anemia, abdominal cramps, and bilateral wrist (or foot) drop should lead any physician to consider the diagnosis of lead intoxication. This case also illustrates the importance of a careful and meticulous social history in patient management.

Key words

lead intoxicationplumbismascites

Copyright information

© Society of General Internal Medicine 2006

Authors and Affiliations

  • Peter Dedeken
    • 1
  • Vernon Louw
    • 2
    • 3
  • Ann-Karolien Vandooren
    • 2
  • Geert Verstegen
    • 4
  • Willy Goossens
    • 4
  • Bénédicte Dubois
    • 1
  1. 1.Department of NeurologyUniversity Hospital GasthuisbergLeuvenBelgium
  2. 2.Department of HaematologyUniversity Hospital GasthuisbergLeuvenBelgium
  3. 3.Clinical Haematology Unit, Department of Internal MedicineUniversitas HospitalBloemfonteinSouth Africa
  4. 4.Department of Laboratory MedicineUniversity Hospital GasthuisbergLeuvenBelgium