Subacute motor polyneuropathy secondary to lead poisoning

Abstract

The clinical manifestations of lead poisoning are varied and nonspecific and remain a diagnostic challenge, especially when they are product of infrequent presentations such as the secondary to intraarticular gun fire fragments. In its broad spectrum of manifestations, changes ranging from attention deficit disorder to more advanced states like polyneuropathies have been described. The diagnosis is based mainly on the measurement of metal in various elements of the patient, and treatment in general supportive measures and chelation therapy.

The case of a man with a history of gunshot wound in right hip with a progressive clinical picture of abdominal pain, anemia accompanied by basophilic stippling and neurological manifestations is described. The electromyography reported a motor and sensory axonal demyelinating polyneuropathy. Serum levels of lead were 113 µg/dL (normal range up 10 µg/dL) and after a treatment regimen with calcium disodium edetate (EDTA ) plus D penicillamine, the neurological symptoms improved, associated with a serum lead control of 49.1 µg/dL.

Conclusion: lead poisoning causes subacute motor polyneuropathy especially in patients with prolonged exposure and high serum lead levels.