Quadriparesis Caused by Lead Poisoning Nine Years After a Gunshot Wound With Retained Bullet Fragments: A Case Report.

MedStar author(s):
Citation: Pm & R. , 2016 Oct 06Pm & R. 9(4):411-414, 2017 AprPMID: 27721003Institution: MedStar National Rehabilitation Network | MedStar Washington Hospital CenterDepartment: RadiologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Foreign Bodies/su [Surgery] | *Lead Poisoning/et [Etiology] | *Quadriplegia/et [Etiology] | *Wounds, Gunshot/co [Complications] | Adult | Chelation Therapy/mt [Methods] | Femur/su [Surgery] | Follow-Up Studies | Humans | Lead Poisoning/pp [Physiopathology] | Male | Quadriplegia/pp [Physiopathology] | Quadriplegia/th [Therapy] | Rare Diseases | Severity of Illness Index | Time FactorsYear: 2016ISSN:
  • 1934-1482
Abstract: Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.Lead toxicity in adults is characterized by nonspecific symptoms of abdominal pain, vomiting, constipation, fatigue, and weight loss. We present a case of severe lead toxicity that developed subacutely, causing quadriparesis 9 years after a gunshot wound with retained bullet fragments. The onset of symptoms may have been related to the development of a pseudocyst. The long interval between the gunshot wound and the onset of symptoms contributed to a delay in suspecting that the retained bullet was a source of lead toxicity. The patient's symptoms gradually improved after chelation therapy, removal of the bullet fragment, and an extended program of acute inpatient rehabilitation.LEVEL OF EVIDENCE: To be determined.All authors: Bunning RD, Jelinek J, Nally EFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2017-05-24
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Journal Article MedStar Authors Catalog Article 27721003 Available 27721003

Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Lead toxicity in adults is characterized by nonspecific symptoms of abdominal pain, vomiting, constipation, fatigue, and weight loss. We present a case of severe lead toxicity that developed subacutely, causing quadriparesis 9 years after a gunshot wound with retained bullet fragments. The onset of symptoms may have been related to the development of a pseudocyst. The long interval between the gunshot wound and the onset of symptoms contributed to a delay in suspecting that the retained bullet was a source of lead toxicity. The patient's symptoms gradually improved after chelation therapy, removal of the bullet fragment, and an extended program of acute inpatient rehabilitation.

LEVEL OF EVIDENCE: To be determined.

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