RT Journal Article
SR Electronic
T1 Chronic lead poisoning in an Iranian opium smoker resident in London
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr2016215965
DO 10.1136/bcr-2016-215965
VO 2016
A1 Alex Azizi
A1 Katie Ferguson
A1 Sam Dluzewski
A1 Tajammul Hussain
A1 Martin Klein
YR 2016
UL http://casereports.bmj.com/content/2016/bcr-2016-215965.abstract
AB A 46-year-old man of Iranian origin presented with a 4-day history of colicky abdominal pain and absolute constipation on a background of several weeks of irritability and malaise. He had smoked 10 g of opium per week for a year and a half. On examination, he had diffuse abdominal tenderness and faecal loading. This was cleared, but the abdominal pain, nausea and vomiting persisted. He had extravascular haemolytic anaemia with punctate basophilic stippling on blood film. The patient's serum lead concentration was substantially elevated and he perhaps demonstrated Burton's line. The patient underwent chelation therapy and has recovered clinically and biochemically. Public health experts were notified and conducted an assessment of the risk to the patient and others; their lead exposure questionnaire was subsequently amended. This is an important case report of a UK resident describing lead toxicity secondary to the inhalation of opium.