Lead Poisoning Is a Rare Diagnosis in a Family with Chronic Abdominal Pain; A Case Report.

Lead poisoning is a significant health concern that can manifest as chronic abdominal pain. We recently documented instances of lead poisoning within a family that resulted from prolonged exposure to deteriorating lead plumbing. The affected individuals exhibited abdominal discomfort and demonstrated marked improvement following chelation therapy. A 20-year-old male with no notable medical history sought medical attention at our emergency department due to chronic abdominal pain that had persisted for a duration of two months, exacerbating over the previous five days. Laboratory evaluations revealed microcytic anemia and positive toxicological results for opiates. Abdominopelvic computed tomography (CT) scans identified multiple punctate densities and fecal impactions in the ascending colon and cecum. Upon further investigation, it was disclosed that the patient resided in a building equipped with aging water pipes. Blood analysis indicated an elevated plasma lead level (PLL) of 87 μg/dl, significantly exceeding the normal range of less than 10 μg/dl, thereby raising a strong suspicion of lead intoxication. The positive opiate toxicology results were attributed to chronic use of analgesics. Interestingly, during his hospitalization, the patient's 57-year-old mother presented to our clinic with similar chronic abdominal pain accompanied by symptoms of depression and irritability. Despite prior investigations, including endoscopy, colonoscopy, ultrasound, and CT scans yielding normal results, blood tests revealed evidence of normocytic anemia. Testing for PLL similarly indicated elevated levels (67 μg/dl), akin to her son's. The administration of chelation therapy using dimercaprol and sodium calcium edetate substantially improved abdominal symptoms. In addition to medical treatment, we provided practical recommendations, advising the family to alter their living conditions and facilitating connections with local real estate agents. Six months post-treatment, follow-up assessments showed increased hemoglobin levels and a significant decline in PLL.