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Lead Poisoning in an Adult: Lead Mobilization by Pregnancy?

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Abstract

We report a case of acute lead poisoning in an adult female who had last been exposed to lead 7 years ago. She presented with abdominal pain, knee pain, and neurological symptoms, hypertension, chronic kidney disease, and anemia with basophilic stippling and lead gum lines. Compared to during her recent pregnancy, her lead level had almost tripled in 5 months to 81 mcg/dL. Chelation therapy was initiated and improved the patient’s symptoms and lead level significantly. In the absence of any new lead exposure or other reasons for increased bone turnover, this acute lead increase was likely due to skeletal mobilization caused by increased resorption from mineralized tissue during and after her pregnancy. This case report illustrates the seriousness of long-term health effects associated with lead poisoning at a multi-organ level, even years after the initial exposure. Thus, patient care should not be limited to the acute treatment of increased lead levels, but also include prevention of increased mobilization and bone turnover and appropriate patient education. In this context, we review various aspects of lead toxicity, especially during pregnancy and lactation.

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Acknowledgments

Funding was provided exclusively by institutional support.

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None disclosed.

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Authors and Affiliations

  1. Department of Anesthesiology, Medical College of Wisconsin, MEB 4250, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA

    Matthias L. Riess MD, PhD

  2. University of Wisconsin School of Medicine and Public Health-Milwaukee Clinical Campus, Milwaukee, WI, USA

    Josiah K. Halm MD, MS

  3. Hospitalist Program, Department of Medicine, Aurora Sinai Medical Center, Milwaukee, WI, USA

    Josiah K. Halm MD, MS

Authors
  1. Matthias L. Riess MD, PhD
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  2. Josiah K. Halm MD, MS
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Correspondence to Matthias L. Riess MD, PhD.

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Riess, M.L., Halm, J.K. Lead Poisoning in an Adult: Lead Mobilization by Pregnancy?. J GEN INTERN MED 22, 1212–1215 (2007). https://doi.org/10.1007/s11606-007-0253-x

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  • DOI: https://doi.org/10.1007/s11606-007-0253-x

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