Evaluation, diagnosis, and treatment of lead poisoning in a patient with occupational lead exposure: a case presentation

Lead is a ubiquitous and versatile metal which has been used by mankind for many years. It ranks as one of the most serious environmental poisons amongst the toxic heavy metals all over the world. Mankind has used it for many years because of its wide variety of applications. Human exposure to lead is from numerous sources and a myriad of pathways including air, food, dust, soil and water. The common sources of lead exposure are use of certain products containing lead such as lead soldered cans, traditional practices such as folk remedies, cosmetics, artisan ceramics, environmental emissions containing lead and very importantly through occupations such as production, use and recycling of lead, lead smelting, refining, alloying and casting, lead acid battery manufacture and breaking, printing, jewellery making [1-5]. Many workers who are working in the lead based industries are ignorant of the ill effects of lead hence do not take proper precaution while handling it, leading to higher level of exposure. This case report emphasizes the management a of lead poisoning case. The following sections provide an overview of the evaluation, diagnosis and treatment.We present a case of twenty-two-year old male admitted to our hospital with the complaints of pain in the upper abdomen, decreased sleep and appetite, general body ache, tiredness, shoulder joint pain, shaking of hands, and wrist drop. On examination he was noted to have basal metabolic index (BMI): 17.2, Pallor: ++, Coarse tremor: ++, BP: 160/100, Pulse: 78/mt, Blue line at gingivodental junction, grade 0 power of extensors of right wrist & fingers; Intrinsic hand muscles- normal, Other limbs- normal power. Reflexes: Supinator- absent, Triceps- weak, Other deep tendon reflexes- normal, Superficial reflexes- normal, Involuntary movement- tremor, Sensory, Cerebellar, Skull & Spine- normal.Relevant history revealed that he had been working in an unorganized lead based manufacturing unit since 6 years. He claimed to be