Fernández Sara, Pollio Gerónimo-Antonio, Domínguez Verónica, Nogué Santiago, Torra Mercè, Cardellach Francesc
Servicio de Medicina Interna, Hospital Clínic, Barcelona, España.
Sección de Toxicología Clínica, Hospital Clínic, Barcelona, España.
Med Clin (Barc). 2015 Feb 20;144(4):166-9. doi: 10.1016/j.medcli.2013.09.048. Epub 2014 Feb 20.
Lead poisoning is normally caused by repeated occupational inhalation of lead. However, lead may also be absorbed through the digestive route. Some alternative medical treatments, such as Ayurvedic medicine, can also contain lead and may result in poisoning.
We collected cases of lead poisoning related to Ayurvedic treatments attended at the Hospital Clinic of Barcelona.
Two female patients, aged 45 and 57 years, respectively, who initiated Ayurvedic treatments which involved the ingestion of various medicaments, were included. The first patient presented with anemia and abdominal pain. The lead level was 74μg/dL and free erythrocyte protoporphyrin was 163μg/dL. She was treated with intravenous calcium disodium ethylenediaminetetraacetic acid (CaNa2EDTA) and later with oral dimercaptosuccinic acid (DMSA) with a good evolution. The second patient presented with abdominal pain and a Burton's line. The lead level was 52μg/dL and free erythrocyte protoporphyrin was 262μg/dL. She was treated with oral DMSA and evolved favorably. Lead concentrations in some of the tablets supplied to the patients reached 2,003 and 19,650μg/g of tablet.
Lead poisoning may result from treatments based on Ayurvedic medicine and may reach epidemic proportions. Health control of alternative medicines is necessary.
铅中毒通常是由于职业性反复吸入铅所致。然而，铅也可通过消化道吸收。一些替代医学疗法，如阿育吠陀医学，也可能含有铅并导致中毒。
我们收集了在巴塞罗那医院诊所接受阿育吠陀治疗相关的铅中毒病例。
纳入了两名分别为45岁和57岁的女性患者，她们开始了涉及摄入各种药物的阿育吠陀治疗。第一名患者出现贫血和腹痛。铅水平为74μg/dL，游离红细胞原卟啉为163μg/dL。她接受了静脉注射依地酸钙钠（CaNa2EDTA）治疗，随后口服二巯基丁二酸（DMSA），病情好转。第二名患者出现腹痛和伯顿线。铅水平为52μg/dL，游离红细胞原卟啉为262μg/dL。她接受了口服DMSA治疗，病情好转。提供给患者的一些片剂中的铅浓度分别达到2,003和19,650μg/g。
基于阿育吠陀医学的治疗可能导致铅中毒，且可能达到流行程度。对替代药物进行健康管控很有必要。
