Singh Omender, Mahajan Monica, Juneja Deven, Mohammed Faizal
Principal Director, Institute of Critical Care Medicine, Max Super Speciality Hospital, New Delhi, Delhi, India.
Director, Department of Internal Medicine, Max Super Speciality Hospital, New Delhi, Delhi, India.
J Assoc Physicians India. 2025 Jan;73(1):e21-e23. doi: 10.59556/japi.73.0806.
An increasing number of cases of lead toxicity are being reported among patients taking Ayurvedic and other alternative medicines. These medicines may have varying amounts of heavy metals, making the diagnosis confusing and treatment challenging. The unavailability of certain chelating agents in resource-poor settings limits therapeutic options.
A 38-year-old, recently diagnosed diabetic male, presented with complaints of vomiting, abdominal pain, and constipation. There was a history of consumption of Ayurvedic medications and other herbal supplements for the past 2 months. Serum lead levels were 120 µg/dL, for which intramuscular dimercaprol was initiated. Other heavy metals, selenium, nickel, and zinc, were also in the higher range. Due to worsening neurological symptoms and unavailability of calcium disodium edetate (CaNaEDTA), D-penicillamine was added to the therapy. Clinical improvement was noted, but D-penicillamine was replaced with CaNaEDTA after a few days, when it became available. The patient was discharged from the hospital with no neurological sequelae.
Lead poisoning should be suspected in patients taking Ayurvedic or herbal medicines and presenting with unexplained abdominal or neurological symptoms. Early diagnosis and chelation therapy may improve outcomes. Combination therapy may be tried in patients with severe poisoning.
服用阿育吠陀药物及其他替代药物的患者中，铅中毒病例报告日益增多。这些药物可能含有不同量的重金属，导致诊断困难且治疗具有挑战性。资源匮乏地区某些螯合剂的短缺限制了治疗选择。
一名38岁、近期诊断为糖尿病的男性患者，出现呕吐、腹痛和便秘症状。过去2个月有服用阿育吠陀药物及其他草药补充剂的病史。血清铅水平为120µg/dL，为此开始肌肉注射二巯丙醇。其他重金属，如硒、镍和锌，也处于较高水平。由于神经症状恶化且无法获得依地酸钙钠（CaNaEDTA），遂在治疗中加用D-青霉胺。临床症状有所改善，但几天后有了CaNaEDTA后，D-青霉胺被其替代。患者出院时无神经后遗症。
服用阿育吠陀药物或草药且出现不明原因腹痛或神经症状的患者应怀疑铅中毒。早期诊断和螯合治疗可能改善预后。重度中毒患者可尝试联合治疗。
