A Case Report of Abdominal Pain and Increased Transaminases Due To Lead Poisoning

Document Type : Case report


1 Associate Professor of Gastroenterology, Mashhad University of Medical Sciences, Mashhad, Iran

2 Resident of Internal Medicine, Mashhad University of Medical Sciences, Mashhad, Iran


Lead poisoning can present with nonspecific signs and symptoms such as abdominal pain, constipation, irritability, difficulty concentrating, and anemia. [
Case report
A 57-years-old Was man admitted to the hospital due to abdominal pain of 40 days duration and 9 kg of weight loss. He had addiction to the oral opium from years ago. He had anemia and jaundice in physical exam .His abdominal pain was after eating and we evaluated upper and lower parts of gastrointestinal and we didn’t find any clue. All of the other imagings incuding,small bowel follow through,abdominal C.T. angiography and magnetic resonance enterography were normal. Finally,serum lead levels were measured and were 1961 mic/ dl (normal range of 10 mic/dl)elevated;Therefore established diagnosis was lead poisoning.
We reported a patient with lead poisoning that was presented with abdominal pain and abnormal liver biochemistries. Because of his addiction to the oral opium agents and some reports, it seems the most probable source of lead poisoning is oral opium agent.


1. Fred M .Henretig .Goldfrank's toxicologic emergencie.9th ed.2011; 94; 1269-1280.
2. ATSDR. Toxicological Profile for Lead. US Department of Health & Human Services, Public Health Service,
Agency for Toxic Substances and Disease Registry, Atlanta, GA 2007. Available at:
www.atsdr.cdc.gov/toxprofiles/tp13.html#bookmark05. (Accessed June 1, 2008):
3. Fischbein A, Hu H. Occupational and environmental exposure to lead. In: Rom WN, Markowitz SB. Editors.
Environmental and Occupational Medicine. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2007. p. 958.
4. Morgan BW, Barnes L, Parramore CS, Kaufmann RB. Elevated blood lead levels associated with the consumption of
moonshine among emergency department patients in Atlanta, Georgia. Ann Emerg Med 2003; 42:351.
5. Rabinowitz MB. Toxicokinetics of bone lead. Environ Health Perspect 1991; 91:33.
6. Hryhorczuk DO, Rabinowitz MB, Hessl SM, Hoffman D, Hogan MM, Mallin K, et al. Elimination kinetics of blood
lead in workers with chronic lead intoxication. Am J Ind Med 1985; 8:33.
7. Aghaee-Afshar M, Khazaeli P, Behnam B, Rezazadehkermani M, Ashraf-Ganjooei N.Department of Surgery,
Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.Presence of lead in opium.
2008; 11:553-4. PMID: 18759525 [PubMed - indexed for MEDLINE].
8. Masoodi M, Zali MR, Ehsani-Ardakani MJ, Mohammad-Alizadeh AH, Aiassofi K, Aghazadeh R, et al. Abdominal
pain due to lead-contaminated opium: a new source of inorganic lead poisoning in Iran. Arch Iran Med 2006; 9:72-75.
9. Beigmohammadi MT, Aghdashi M, Najafi A, Mojtahedzadeh M, Karvandian K.. Quadriplegia due to leadcontaminated
opium--case report. Middle East J Anesthesiol 2008; 19:1411-6.PMID: 18942257 [PubMed - indexed for
10. Verheij J, Voortman J, van Nieuwkerk CM, Jarbandhan SV, Mulder CJ, Bloemena E. Hepatic morphopathologic
findings of lead poisoning in a drug addict: a case report. J Gastrointestin Liver Dis 2009; 18:225-227.