Extreme gastric dilation caused by chronic lead poisoning: A case report

[Blood and faecal lead levels in children with various functional gastrointestinal disorders]

INTRODUCTION

To investigate the blood lead levels (BLLs) and faecal lead levels (FLLs) in children with various functional gastrointestinal disorders (FGIDs) and compare them with controls.

PATIENTS AND METHODS

One hundred and 2children with FGIDs defined by the Rome IV criteria, aged 4 -18 years, and one hundred and 2sex matched healthy children were enrolled in the study. Children with FGIDs were divided into 3subgroups as functional constipation (FC) (n=36), functional abdominal pain (FAP) (n=36) and functional náusea (FN) (n=30). The lead levels were measured using atomic absorption spectrometer.

RESULTS

The median BLLs in the FGIDs group was significantly higher than in controls (5.12 and 1.77μg/dL, respectively). The BLLs were above 5μg/dL in 51,9% of children with FGIDs. There was statistically significant difference in BLLs between FC subgroup and the other subgroups (FAP and FN) (P=.003, P<.001 respectively). The FLLs in the FGIDs group was significantly higher than in controls (28.08 and 0.01μg/g, respectively). There was no significant difference in FLLs between FC subgroup and the other subgroups (P=.992, P=.989 respectively). No significant relation found between BLLs and FLLs of the FGIDs group (P =.123).

CONCLUSION

This study revealed that children with FGIDs had higher BLLs and FLLs than controls and also more than half of children with FGIDs had BLLs ≥5μg/dL which is toxic level. These results might revive the question of whether or not clinician need to evaluate routine BLLs in children with FGIDs.

Platform- and label-free detection of lead ions in environmental and laboratory samples using G-quadraplex probes by circular dichroism spectroscopy

Guanine-rich quadruplex (G-QD) are formed by conversion of nucleotides with specific sequences by stabilization of positively charged K⁺ or Na⁺. These G-QD structures differentially absorb two-directional (right- and left-handed) circularly polarized light, which can discriminate the parallel or anti-parallel structures of G-QDs. In this study, G-QDs stabilized by Pb²⁺ were analyzed by a circular dichroism (CD) spectroscopy to determine Pb²⁺ concentration in water samples. Thrombin aptamer (TBA), PS2.M, human telomeric DNA (HTG), AGRO 100, and telomeric related sequence (T2) were studied to verify their applicability as probes for platform- and label-free detection of Pb²⁺ in environmental as well as laboratory samples. Among these nucleotides, TBA and PS2.M exhibited higher binding constants for Pb²⁺, 1.20-2.04 × 10⁶/M at and 4.58 × 10⁴-1.09 × 10⁵/M at 100 micromolar and 100 mM K⁺ concentration, respectively. They also exhibited excellent selectivity for Pb²⁺ than for Al³⁺, Cu²⁺, Ni²⁺, Fe³⁺, Co²⁺, and Cr²⁺. When Pb²⁺ was spiked into an effluent sample from a wastewater treatment plant (WWTP), its existence was detected by CD spectroscopy following a simple addition of TBA or PS2.M. By the addition of TBA and PS2.M, the Pb²⁺ signals were observed in effluent samples over 0.5 micromolar (100 ppb) concentration. Furthermore, PS2.M caused a Pb²⁺-specific absorption band in the effluent sample without spiking of Pb²⁺, and could be induced to G-QD structure by the background Pb²⁺ concentration in the effluent, 0.159 micromolar concentration (3.30 ppb). Taken together, we propose that TBA and PS2.M are applicable as platform- and label-free detection probes for monitoring Pb²⁺ in environmental samples such as discharged effluent from local WWTPs, using CD spectroscopy.

Occupational Lead Poisoning in a Patient with Acute Abdomen and Normocytic Anemia

We herein report a 24-year-old male construction worker with occupational lead poisoning who presented with acute abdomen and normocytic anemia. The levels of urinary delta-aminolevulinic acid and free erythrocyte protoporphyrin were elevated without any increase in the level of urine porphobilinogen. Detection of an elevated blood lead level of 100 μg/dL confirmed a diagnosis of lead poisoning. Chelation therapy with calcium disodium ethylenediaminetetraacetate resulted in prompt improvement of the clinical symptoms and the blood lead level. Clinicians should be aware that lead poisoning caused by occupational exposure can still occur sporadically in construction workers in Japan.

Biochemical and Molecular Bases of Lead-Induced Toxicity in Mammalian Systems and Possible Mitigations

The effects of lead exposure on mammals are reported to be devastating. Lead is present in all the abiotic environmental components such as brass, dust, plumbing fixtures, soil, water, and lead mixed imported products. Its continuous use for several industrial and domestic purposes has caused a rise in its levels, thereby posing serious threats to human health. The mechanisms involved in lead-induced toxicity primarily include free-radical-mediated generation of oxidative stress which directly imbalances the prooxidants and the antioxidants in body. The toxicity of lead involves damage primarily to major biomolecules (lipid, protein, and nucleic acids) and liver (hepatotoxicity), nervous system (neurotoxicity), kidney (nephrotoxicity) and DNA (genotoxicity), present in animals and humans. The activation of c-Jun NH2-terminal kinase, phosphoinositide 3-kinase, or Akt and p38 mitogen activated protein kinase signaling pathways are important for lead cytotoxicity. Lead increased apoptosis through signaling cascade and associated factors and significantly impairs cell differentiation and maturation. In addition, lead has great impact on metabolic pathways such as heme synthesis, thereby leading to the onset of anemia in lead exposed people. This review encompasses an updated account of varied aspects of lead-induced oxidative stress and the biomolecular consequences such as perturbations in physiological processes, apoptosis, carcinogenesis, hormonal imbalance, loss of vision, and reduced fertility and their possible remediation through synthetic (chelators) and natural compounds (plant-based principles). This paper is primarily concerned with the biomedical implications of lead-induced generation of free radical and the toxicity management in the mammalian system.

Lead Toxicity, Antioxidant Defense and Environment

Environmental and occupational exposure to a large number of chemicals occurs at various stages throughout human life. Many of these are devoid of toxicity, but some could pose a significant health risk, i.e. the exposure to environmental xenobiotic metals as lead, mercury (Sinicropi et al. 2010a; Carocci et al. 2014), cadmium, etc. In particular, lead has long been a widespread public concern (Basha and Reddy 2010). Lead is one of the earliest heavy metals discovered by men. Due to its unique properties, as low melting point, softness, malleability, ductility, and resistance to corrosion, men have used lead for the last 5000 years in a wide range of applications.

Lead poisoning by intradiscal firearm bullet: a case report

STUDY DESIGN

The report of a rare case of lead poisoning by an intradiscal firearm bullet is presented.

OBJECTIVE

To describe and discuss the clinical and radiologic features (by computed tomography and magnetic resonance imaging) of a gunshot wound in the L2-L3 space which caused lead poisoning 5 years afterwards.

SUMMARY OF BACKGROUND DATA

Lead poisoning from firearm bullets is rare, but the possibility should be investigated in the case of bullets lodged in the joints.

METHODS

A 30-year-old man presented to the emergency room with an intense lumbar pain complaint, colic, intestinal constipation, insomnia, and progressive headache for 20 days. He had a history of a gunshot wound 5 years previously, and the bullet was left in situ, in the intravertebral disc between L2 and L3, as confirmed by radiographs, computed tomography, and magnetic resonance imaging. The hypothesis of lead poisoning was confirmed by the laboratory results. Chelation treatment with calcium versenate (disodium ethylenediaminetetraacetate, or CaNa (2) EDTA) was indicated. The patient was admitted and treated once again, before surgical removal of the bullet.

RESULTS

After removal of the bullet, the patient had an episode of recurrence, and a new chelation cycle was performed, with complete resolution.

CONCLUSION

Lead poisoning can result in severe clinical disorders that require rapid treatment. In this case, both clinical and surgical treatments led to complete resolution of the symptoms.