Severe lead toxicity attributed to bullet fragments retained in soft tissue. BMJ Case Rep 2017 Mar 08;2017
Date
03/10/2017Pubmed ID
28275014Pubmed Central ID
PMC5353372DOI
10.1136/bcr-2016-217351Scopus ID
2-s2.0-85015243781 (requires institutional sign-in at Scopus site) 9 CitationsAbstract
A man aged 30 years presented to an emergency department with a 1 month history of severe abdominal pain, jaundice, constipation, lower extremity weakness and weight loss. A peripheral blood smear was performed that showed basophilic stippling of erythrocytes prompting a blood lead level (BLL) evaluation. The patient had a BLL of >200 µg/dL. Retained bullet fragments were identified in the left lower extremity from a previous gunshot wound 10 years prior. Lead from the excised bullet fragment was consistent with the patient's blood lead by isotope ratio analysis. This case is a rare example of a severely elevated BLL attributed to bullet fragments in soft tissue. Bullets retained in soft tissue are not often considered a risk factor for a markedly elevated BLL because they become encapsulated within the tissue over time.
Author List
Weiss D, Lee D, Feldman R, Smith KEAuthor
Ryan J. Feldman PharmD Adjunct Assistant Professor in the School of Pharmacy Administration department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultDisease Management
Foreign Bodies
Humans
Lead Poisoning
Male
Wounds, Gunshot
