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Autonomic dysfunction due to lead poisoning.

Kushal Madan1, Praveen Kumar Sharma, Govind Makharia

  • 1Department of Physiology, All India Institute of Medical Sciences, Ansari Nagar-110029, New Delhi, India.

Autonomic Neuroscience : Basic & Clinical
|November 23, 2006
PubMed
Summary
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This case study shows that lead poisoning can cause autonomic dysfunction and intestinal issues. Treatment with Meso-2,3-dimercaptosuccinic acid (DMSA) improved autonomic function and reduced lead levels.

Area of Science:

  • Neurology
  • Toxicology
  • Gastroenterology

Background:

  • Lead poisoning is a serious condition that can affect multiple organ systems.
  • Autonomic dysfunction can manifest in various ways, impacting bodily functions.
  • Intestinal pseudo-obstruction is a motility disorder that mimics mechanical blockage.

Observation:

  • A 24-year-old male presented with autonomic dysfunction, intestinal pseudo-obstruction, and anemia attributed to lead poisoning.
  • Blood lead levels were significantly elevated initially (98.8 microg/dL) and gradually decreased with treatment.
  • Autonomic function tests revealed severe loss of autonomic tone and reactivity at baseline.

Findings:

  • Treatment with Meso-2,3-dimercaptosuccinic acid (DMSA) led to a progressive decline in blood lead levels.

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  • Concurrent improvement in autonomic functions was observed as lead levels decreased.
  • By week 52, most autonomic parameters normalized, with only mild residual parasympathetic reactivity loss.

    • Implications:

    • This case highlights the potential for lead poisoning to cause significant autonomic and gastrointestinal disturbances.
    • Chelation therapy with DMSA can effectively reduce lead burden and reverse associated neurological deficits.
    • Early diagnosis and intervention are crucial for managing lead toxicity and improving patient outcomes.