Case Report

Journal of General Internal Medicine

, Volume 21, Issue 6, pp C1-C3

Plumbism or lead intoxication mimicking an abdominal tumor

  • Peter DedekenAffiliated withDepartment of Neurology, University Hospital Gasthuisberg
  • , Vernon LouwAffiliated withDepartment of Haematology, University Hospital GasthuisbergClinical Haematology Unit, Department of Internal Medicine, Universitas Hospital
  • , Ann-Karolien VandoorenAffiliated withDepartment of Haematology, University Hospital Gasthuisberg
  • , Geert VerstegenAffiliated withDepartment of Laboratory Medicine, University Hospital Gasthuisberg
  • , Willy GoossensAffiliated withDepartment of Laboratory Medicine, University Hospital Gasthuisberg
  • , Bénédicte DuboisAffiliated withDepartment of Neurology, University Hospital Gasthuisberg Email author 

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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 intoxication plumbism ascites