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[A "historical" case of lead poisoning via drinking water: diagnostic and therapeutic issues]
F Testud1, L Girtanner-Brunel, P Y Péaud
1Unité de toxicovigilance, centre antipoison, hôpital Edouard-Herriot, place d'Arsonval, 69437 Lyon, France.
Introduction:
It is likely that lead poisoning via drinking water is often overlooked because of its supposed rarity and nonspecific early symptoms, which result in delayed management.
Exegesis:
One case of severe lead poisoning via drinking water is reported. The diagnosis was long missed and a particularly long chelating treatment was required. The clinical features included lead colic, a Burton's lead line, anemia, polyneuritis and arterial hypertension. Eighteen courses of calcium EDTA were required to obtain 'biological recovery'. The poisoning was linked to a very long water supply lead pipe and potomania secondary to alcohol withdrawal.
Conclusion:
This case report illustrates how difficult the early recognition of lead poisoning can be, and underlines the need to inquire about a toxic aetiology, particularly via the environment, of otherwise unexplained pathological conditions.