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We report a patient with lead intoxication who had both acute encephalopathy and motor neuropathy. This case illustrates how difficult it can be to find the source of a lead intoxication because patients may not be aware of lead exposure.
Case report.
A 68-year-old woman was admitted to our hospital in October 2003, with a 1-month history of fatigue, vomiting, and abdominal pain. Clinical examination revealed hypertension as a new finding but was otherwise normal. Blood test showed a macrocytic anemia and basophilic stippling of erythrocytes on blood smear. Vitamin B12 level was 141 nmol/L (normal range [NR] 179 to 660). Erythropoietin level (30 IU/L [NR 12.0 to 23.0]) was lower than expected for a hemoglobulin of 78 g/L [NR 120 to 160]). Bone marrow aspirate revealed increased dysplastic erythropoiesis. A differential diagnosis of myelodysplastic syndrome or reactive changes was made.
One month later, the patient was rehospitalized because of two tonic-clonic seizures. Neurologic examination was normal. Brain MRI showed …
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- LEAD POISONING FROM THE BEAUTY CASE: NEUROLOGIC MANIFESTATIONS IN AN ELDERLY WOMAN
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