Dunbabin D W, Tallis G A, Popplewell P Y, Lee R A
Flinders Medical Centre, Bedford Park, Sa.
Med J Aust. 1992;157(11-12):835-6. doi: 10.5694/j.1326-5377.1992.tb141305.x.
To present a case of lead poisoning following ingestion of Indian herbal medicine.
A 37-year-old man presented with a history of abdominal pain, anorexia and malaise. He had recently returned from a trip to India where he had been taking two different herbal tonics. Investigation revealed low-grade hepatitis and normocytic anaemia with prominent basophilic stippling. The blood lead concentration was high, and analysis of the herbal tablets revealed a very high lead content.
The patient required narcotic analgesia for abdominal pain and was treated with chelation therapy with calcium ethylenediaminetetra-acetate (calcium EDTA) for five days which resulted in a high urinary excretion of lead and resolution of his symptoms over a period of several days.
Lead poisoning in Australia is usually the result of chronic industrial exposure, but practitioners should be aware of the possibility of poisoning from other domestic sources such as unglazed pottery, cosmetics and herbal remedies, especially those from Asia and India, in which lead may be present in high concentration. Patients from Asia who present with unexplained anaemia or abdominal symptoms should be asked about exposure to such sources.
报告一例因摄入印度草药而导致铅中毒的病例。
一名37岁男性,有腹痛、厌食和不适病史。他最近刚从印度旅行归来,在那里他一直在服用两种不同的草药滋补品。检查发现轻度肝炎和正细胞性贫血,并伴有明显的嗜碱性点彩。血铅浓度很高,对草药片剂的分析显示铅含量极高。
患者因腹痛需要使用麻醉性镇痛药,并接受了五天的依地酸钙钠(钙螯合剂)螯合疗法,这导致铅的尿排泄量增加,且其症状在数天内得到缓解。
在澳大利亚,铅中毒通常是慢性工业接触的结果,但从业者应意识到其他家庭来源导致中毒的可能性,如无釉陶器、化妆品和草药,尤其是来自亚洲和印度的,其中铅含量可能很高。对于出现不明原因贫血或腹部症状的亚洲患者,应询问其是否接触过此类来源。