铅污染鸦片所致四肢瘫痪——病例报告

Quadriplegia due to lead-contaminated opium--case report.

作者信息

Beigmohammadi Mohammad Taghi, Aghdashi Moosa, Najafi Atabak, Mojtahedzadeh Mojtaba, Karvandian Kassra

机构信息

Department of Anesthesiology & Intensive Care, Imam Khomeini Hospital, Tehran Univ. of Medical Sciences, Tehran, Iran.

出版信息

Middle East J Anaesthesiol. 2008 Oct;19(6):1411-6.

PMID:18942257

Abstract

PURPOSE

Utilization of lead-contaminated opium may lead to severe motor neuron impairment and quadriplegia.

CASE REPORT

Forty years oriented old male, opium addict, was admitted to the ICU, with headache, nausea and abdominal pain, and weakness in his lower and upper extremities without definitive diagnosis. The past medical and occupational history was negative. Laboratory investigation showed; anemia (Hb 7.7 g/dl), slightly elevated liver function tests, elevated total bilirubin, and ESR. Abdominal sonography and brain CT scan were normal. EMG and NCV results and neurologic examination were suggestive for Guillain-Barre. He underwent five sessions of plasmapheresis. Blood lead level was > 200 microg/dl. He received dimercaprol (BAL) and calcium disodium edetate (CaEDTA) for two five days session. Upon discharge from ICU all laboratory tests were normal and blood lead level was reduced, but he was quadriplegic.

CONCLUSION

The delayed treatment of lead poisoning may lead to irreversible motor neuron defect.

摘要

目的

使用铅污染的鸦片可能导致严重的运动神经元损伤和四肢瘫痪。

病例报告

一名40岁男性鸦片成瘾者入住重症监护病房，有头痛、恶心、腹痛症状，上下肢无力，未明确诊断。既往病史和职业史均无异常。实验室检查显示：贫血（血红蛋白7.7g/dl）、肝功能检查轻度升高、总胆红素升高及血沉升高。腹部超声和脑部CT扫描正常。肌电图和神经传导速度结果以及神经系统检查提示吉兰 - 巴雷综合征。他接受了5次血浆置换。血铅水平>200μg/dl。他接受了二巯丙醇（BAL）和依地酸钙钠（CaEDTA）治疗，为期两个五天疗程。从重症监护病房出院时，所有实验室检查均正常，血铅水平降低，但他已四肢瘫痪。