Hugelmeyer C D, Moorhead J C, Horenblas L, Bayer M J
Division of Emergency Medicine, Oregon Health Sciences University, Portland.
J Emerg Med. 1988 Sep-Oct;6(5):397-400. doi: 10.1016/0736-4679(88)90013-3.
A 23-month-old female child presented to an emergency department with a mild, nonspecific gastrointestinal illness and periodic fussiness and irritability; the initial physical examination was nonfocal and nondiagnostic. Rapid decompensation quickly ensued. Postmortem examination of hematologic laboratory data and reevaluation of radiographs showed a metallic foreign body in the stomach. Diagnosis of rapidly fatal lead encephalopathy was confirmed by finding toxic serum lead and elevated delta-aminolevulinic (ALA) levels in postmortem blood.
一名23个月大的女童因轻度、非特异性胃肠道疾病以及周期性烦躁和易怒前往急诊科就诊;初次体格检查未发现局灶性病变,也未明确诊断。随后很快出现快速失代偿。对血液学实验室数据进行尸检以及对X光片进行重新评估后发现胃内有金属异物。通过在尸检血液中发现有毒血清铅和升高的δ-氨基乙酰丙酸(ALA)水平,确诊为快速致命性铅脑病。