Lead Poisoning Can Be Easily Misdiagnosed as Acute Porphyria and Nonspecific Abdominal Pain

Lead poisoning (LP) is less commonly encountered in emergency departments (ED). However, lead exposure still occurs, and new sources of poisoning have emerged. LP often goes unrecognized due to a low index of suspicion and nonspecific symptoms. We present a case of a 48-year-old man who had recurrin...

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Main Authors: Ming-Ta Tsai, Shi-Yu Huang, Shih-Yu Cheng
Format: Article
Language:English
Published: Hindawi Limited 2017-01-01
Series:Case Reports in Emergency Medicine
Online Access:http://dx.doi.org/10.1155/2017/9050713
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spelling doaj-81f1772973994981b69fa9573c664f6a2020-11-25T00:02:14ZengHindawi LimitedCase Reports in Emergency Medicine2090-648X2090-64982017-01-01201710.1155/2017/90507139050713Lead Poisoning Can Be Easily Misdiagnosed as Acute Porphyria and Nonspecific Abdominal PainMing-Ta Tsai0Shi-Yu Huang1Shih-Yu Cheng2Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, TaiwanLead poisoning (LP) is less commonly encountered in emergency departments (ED). However, lead exposure still occurs, and new sources of poisoning have emerged. LP often goes unrecognized due to a low index of suspicion and nonspecific symptoms. We present a case of a 48-year-old man who had recurring abdominal pain with anemia that was misdiagnosed. His condition was initially diagnosed as nonspecific abdominal pain and acute porphyria. Acute porphyria-like symptoms with a positive urine porphyrin test result led to the misdiagnosis; testing for heme precursors in urine is the key to the differential diagnosis between LP and acute porphyria. The final definitive diagnosis of lead toxicity was confirmed based on high blood lead levels after detailed medical history taking. The lead poisoning was caused by traditional Chinese herbal pills. The abdominal pain disappeared after a course of chelating treatment. The triad for the diagnosis of lead poisoning should be a history of medicine intake, anemia with basophilic stippling, and recurrent abdominal pain.http://dx.doi.org/10.1155/2017/9050713
collection DOAJ
language English
format Article
sources DOAJ
author Ming-Ta Tsai
Shi-Yu Huang
Shih-Yu Cheng
spellingShingle Ming-Ta Tsai
Shi-Yu Huang
Shih-Yu Cheng
Lead Poisoning Can Be Easily Misdiagnosed as Acute Porphyria and Nonspecific Abdominal Pain
Case Reports in Emergency Medicine
author_facet Ming-Ta Tsai
Shi-Yu Huang
Shih-Yu Cheng
author_sort Ming-Ta Tsai
title Lead Poisoning Can Be Easily Misdiagnosed as Acute Porphyria and Nonspecific Abdominal Pain
title_short Lead Poisoning Can Be Easily Misdiagnosed as Acute Porphyria and Nonspecific Abdominal Pain
title_full Lead Poisoning Can Be Easily Misdiagnosed as Acute Porphyria and Nonspecific Abdominal Pain
title_fullStr Lead Poisoning Can Be Easily Misdiagnosed as Acute Porphyria and Nonspecific Abdominal Pain
title_full_unstemmed Lead Poisoning Can Be Easily Misdiagnosed as Acute Porphyria and Nonspecific Abdominal Pain
title_sort lead poisoning can be easily misdiagnosed as acute porphyria and nonspecific abdominal pain
publisher Hindawi Limited
series Case Reports in Emergency Medicine
issn 2090-648X
2090-6498
publishDate 2017-01-01
description Lead poisoning (LP) is less commonly encountered in emergency departments (ED). However, lead exposure still occurs, and new sources of poisoning have emerged. LP often goes unrecognized due to a low index of suspicion and nonspecific symptoms. We present a case of a 48-year-old man who had recurring abdominal pain with anemia that was misdiagnosed. His condition was initially diagnosed as nonspecific abdominal pain and acute porphyria. Acute porphyria-like symptoms with a positive urine porphyrin test result led to the misdiagnosis; testing for heme precursors in urine is the key to the differential diagnosis between LP and acute porphyria. The final definitive diagnosis of lead toxicity was confirmed based on high blood lead levels after detailed medical history taking. The lead poisoning was caused by traditional Chinese herbal pills. The abdominal pain disappeared after a course of chelating treatment. The triad for the diagnosis of lead poisoning should be a history of medicine intake, anemia with basophilic stippling, and recurrent abdominal pain.
url http://dx.doi.org/10.1155/2017/9050713
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AT shiyuhuang leadpoisoningcanbeeasilymisdiagnosedasacuteporphyriaandnonspecificabdominalpain
AT shihyucheng leadpoisoningcanbeeasilymisdiagnosedasacuteporphyriaandnonspecificabdominalpain
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