Lead poisoning from mobilization of bone stores during thyrotoxicosis.
Goldman-RH; White-R; Kales-SN; Hu-H
Am J Ind Med 1994 Mar; 25(3):417-424
A case of lead (7439921) poisoning due to mobilization of bone lead stores during thyrotoxicosis was described. A 37 year old female employed as a clothing store salesperson with complaints of persistent fatigue, insomnia, mental concentration difficulties, abdominal cramps, weight loss, and tremor was evaluated. She had read about lead poisoning and was concerned that her symptoms might be related to work she had performed 7 and 10 years earlier when she removed lead containing paint while renovating houses. Her blood lead level was 51 micrograms per deciliter (microg/dl). Detailed questioning did not reveal any sources of recent lead exposure, but she recalled pica as a child and suffering from chronic abdominal complaints and anemia at the time. Physical examination revealed that she was clinically hyperthyroid. She had a fine resting tremor of both hands and symmetric hyperreflexia. A repeat blood lead test indicated a concentration of 53microg/dl. Bone lead measurements taken at the patient's midtibial shaft and patella using K-X-ray fluorescence indicated bone lead concentrations of 154 and 253 micrograms per gram, respectively. She underwent a course of propylthiouracil therapy, which was followed by thyroid ablation. Her blood lead concentrations decreased as her hyperthyroidism came under better control. Twenty five weeks after thyroid ablation, her blood lead concentration had decreased to 19microg/dl. The authors conclude that increased bone turnover accompanying thyrotoxicosis probably led to the clinically significant lead poisoning observed in this patient as a result of mobilization of bone lead stores acquired many years earlier.
NIOSH-Publication; NIOSH-Grant; Training; Lead-poisoning; Biological-transport; Bone-structure; Case-studies; Clinical-symptoms; Thyroid-gland-disorders; Body-burden; Humans; Environmental-exposure; Occupational-exposure;
Physiology Department, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115
American Journal of Industrial Medicine
Harvard University, Boston, Massachusetts