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Inicio Medicina Clínica (English Edition) Outbreak of lead poisoning associated with ayurvedic medicine
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Vol. 144. Issue 4.
Pages 166-169 (February 2015)
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Vol. 144. Issue 4.
Pages 166-169 (February 2015)
Clinical report
DOI: 10.1016/j.medcle.2015.05.014
Outbreak of lead poisoning associated with ayurvedic medicine
Brote de saturnismo asociado a un tratamiento basado en la medicina ayurvédica
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Sara Fernándeza, Gerónimo-Antonio Pollioa, Verónica Domíngueza, Santiago Noguéb,
Corresponding author
SNOGUE@clinic.ub.es

Corresponding author.
, Mercè Torrac, Francesc Cardellacha
a Servicio de Medicina Interna, Hospital Clínic, Barcelona, Spain
b Sección de Toxicología Clínica, Hospital Clínic, Barcelona, Spain
c Sección de Toxicología Analítica, Hospital Clínic, Barcelona, Spain
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Table 1. Case 1. Blood lead concentration and urine lead concentration and amount of lead excreted through urine of 24h at the beginning, during and at the end of the treatment with chelating agents.
Abstract
Background and objective

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.

Patients and methods

We collected cases of lead poisoning related to Ayurvedic treatments attended at the Hospital Clinic of Barcelona.

Results

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 anaemia 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 favourably. Lead concentrations in some of the tablets supplied to the patients reached 2003 and 19,650μg/g of tablet.

Conclusions

Lead poisoning may result from treatments based on ayurvedic medicine and may reach epidemic proportions. Health control of alternative medicines is necessary.

Keywords:
Saturnism
Lead poisoning
Ayurvedic medicine
Resumen
Fundamento y objetivo

El saturnismo es una enfermedad de causa tóxica que es producida, habitualmente, por la inhalación repetida de plomo en un ámbito laboral. Pero este metal puede también ser absorbido por vía digestiva. En medicinas alternativas, como la ayurvédica, el plomo puede formar parte de algunos tratamientos y ser causa de intoxicación.

Pacientes y método

Se recogen los casos de saturnismo atendidos y tratados en el Hospital Clínic de Barcelona en relación con un tratamiento ayurvédico.

Resultados

Se han incluido 2 mujeres de 45 y 57 años que iniciaron un tratamiento ayurvédico que comprendía la ingesta de diversos medicamentos. El primer caso desarrolló anaemia y dolor abdominal. La plumbemia fue de 74μg/dl y la protoporfirina eritrocitaria de 163μg/dl. Fue tratada con etilendiaminotetraacetato de calcio y disodio (CaNa2EDTA) intravenoso y posteriormente con ácido dimercaptosuccínico (DMSA) oral, con buena evolución. El segundo caso presentó dolor abdominal y un ribete de Burton. La plumbemia fue de 52μg/dl y la protoporfirina eritrocitaria de 262μg/dl. Fue tratada con DMSA oral, evolucionando favorablemente. Las concentraciones de plomo en algunas de las pastillas suministradas a las pacientes fueron de 2.003 y 19.650μg/g de pastilla.

Conclusiones

La intoxicación por plomo puede ser el resultado de un tratamiento basado en la medicina ayurvédica y puede llegar a adquirir características epidémicas. Es necesario un control sanitario de los medicamentos alternativos.

Palabras clave:
Saturnismo
Intoxicación por plomo
Medicina ayurvédica

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