OWN - NLM
DA - 20170309
LR - 20170316
IS - 1757-790X (Electronic)
IS - 1757-790X (Linking)
VI - 2017
DP - 2017 Mar 08
TI - Severe lead toxicity attributed to bullet fragments retained in soft tissue.
LID - bcr2016217351 [pii]
LID - 10.1136/bcr-2016-217351 [doi]
AB - 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 microg/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.
CI - 2017 BMJ Publishing Group Ltd.
FAU - Weiss, Debora
AU - Weiss D
AD - Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology
and Laboratory Services (CSELS), Atlanta, Georgia, USA.
AD - Wisconsin Department of Health Services, Bureau of Environmental and Occupational
Health, Madison, Wisconsin, USA.
FAU - Lee, Don
AU - Lee D
AD - Ascension Columbia St. Mary's, Milwaukee, Wisconsin, USA.
FAU - Feldman, Ryan
AU - Feldman R
AD - Wisconsin Poison Center, Childrens Hospital of Wisconsin, Froedert & the Medical
College of Wisconsin, Milwaukee, Wisconsin, USA.
FAU - Smith, Kate E
AU - Smith KE
AD - University of Wisconsin-Madison, Wisconsin State Laboratory of Hygiene, Trace
Element Research Laboratory, Madison, Wisconsin, USA.
LA - eng
PT - Case Reports
PT - Journal Article
DEP - 20170308
PL - England
TA - BMJ Case Rep
JT - BMJ case reports
JID - 101526291
SB - IM
MH - Adult
MH - Disease Management
MH - Foreign Bodies/complications/*diagnostic imaging
MH - Humans
MH - Lead Poisoning/*blood/etiology
MH - Male
MH - Wounds, Gunshot/*complications
EDAT- 2017/03/10 06:00
MHDA- 2017/03/17 06:00
CRDT- 2017/03/10 06:00
AID - bcr-2016-217351 [pii]
AID - 10.1136/bcr-2016-217351 [doi]
PST - epublish
SO - BMJ Case Rep. 2017 Mar 8;2017. pii: bcr2016217351. doi: 10.1136/bcr-2016-217351.