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Chronická otrava olovom predstavuje zriedkavú formu sekundárnej koproporfýrie. Samotné porfýrie patria do skupiny vzácnych metabolických ochorení, spôsobených vrodeným enzymatickým defektom alebo získanou poruchou syntézy hému. Olovo má inhibičný vplyv na enzýmy podieľajúce sa na syntéze hému. Všetky úvodné symptómy pri chronickej intoxikácii olovom sú nešpecifické a ľahko prehliadnuteľné. Ťažké chronické otravy môžu byť sprevádzané poškodením nervového systému. Naša kazuistika prezentuje prípad pacienta s atypickým klinickým vzorcom delíria pri nadužívaní alkoholu s neuropsychiatrickými a internými komplikáciami. Prácou chceme poukázať na dôležitosť anamnézy a komplexného vyšetrenia pacienta pri širokej škále príznakov, ktoré vyžadujú multiodborový prístup.

Chronic lead poisoning is a rare form of secondary coproporphyria. Porphyrias belong to the group of rare metabolic diseases caused by a congenital enzymatic defect or an acquired disorder of heme synthesis. Lead has an inhibitory effect on enzymes involved in heme synthesis. All initial symptoms of chronic poisoning are non-specific and easily overlooked. Severe chronic poisoning may be accompanied by damage to the nervous system. We report a case of a patient with an atypical clinical pattern of delirium in alcohol overuse with neuropsychiatric and internal complications. The aim of the paper is to highlight the importance of detailed history and comprehensive evaluation of a patient with a wide range of symptoms, requiring a multidisciplinary approach.

Článek online

Acute lead poisoning in an indoor firing range

Medycyna pracy. 2020 ; 71 (3) : 375-379. [pub] 20200228

Med Pr
ISSN 2353-1339
Medvik
Zdroj

The presented case demonstrates that acute lead poisoning may occur due to just short-term exposure to a mixture of lead-containing dust and ammunition. Such exposure may result in high blood lead levels persisting for years in the absence of any symptoms. A middle-aged male with a history of an approximately 7-day cleanup of an old recreational firing range with large ammunition and dust deposits presented to an emergency department with abdominal pain, dyspnea, fatigue and impaired cognitive function. Given his occupational history, specific tests were performed that showed high lead concentrations in both blood and urine. The patient was diagnosed with acute lead poisoning. He was started on chelation therapy that improved both clinical and laboratory parameters. Over a subsequent nearly 3-year follow-up, the patient's blood lead levels fluctuated and continued to be increased. Given the absence of other sources of lead exposure, these were likely due to the formation of bone deposits. Med Pr. 2020;71(3):375-9.

MeSH
akutní nemoc MeSH
bolesti břicha chemicky indukované MeSH
chelátory terapeutické užití MeSH
lidé středního věku MeSH
lidé MeSH
otrava olovem diagnóza farmakoterapie MeSH
pracoviště MeSH
pracovní expozice škodlivé účinky MeSH
střelné zbraně * MeSH
výsledek terapie MeSH
znečištění vzduchu ve vnitřním prostředí škodlivé účinky MeSH
Check Tag
lidé středního věku MeSH
lidé MeSH
mužské pohlaví MeSH
Publikační typ
kazuistiky MeSH
Geografické názvy
Polsko MeSH

Článek

Otrava olovem. Překvapivá příčina bolestí břicha, obstipace a anémie
[Lead poisoning. A surprising cause of constipation, abdominal pain and anemia]

Postgraduální gastroenterologie & hepatologie. 2017 ; 3 (2) : 124-128.

ISSN 2336-4998
Medvik
Zdroj

MeSH
anemie chemicky indukované MeSH
antidota aplikace a dávkování MeSH
bolesti břicha chemicky indukované MeSH
chelátory aplikace a dávkování terapeutické užití MeSH
diferenciální diagnóza MeSH
lidé středního věku MeSH
lidé MeSH
olovo analýza krev MeSH
otrava olovem * diagnóza etiologie farmakoterapie MeSH
zácpa chemicky indukované MeSH
Check Tag
lidé středního věku MeSH
lidé MeSH
mužské pohlaví MeSH
Publikační typ
kazuistiky MeSH

Článek online

Is Central Europe safe from environmental lead intoxications? A case series

Central European Journal of Public Health. 2016 ; 24 (2) : 120-122.

Cent. Eur. J. Public Health
ISSN 1210-7778
Medvik
Zdroj

Preventive measures in Central Europe were successful in suppressing both occupational and environmental lead exposure so that they did not constitute a severe public health problem. However, rare lead intoxications still appear. We report on lead intoxication in four family members where the source was removed lead ceiling paint. The symptoms of the lead intoxication started several weeks after removal and the inhalational exposure to the minimum dust residues lasted for more than three months before the poisoning was diagnosed. Father developed anaemia and saturnine colics. He and his two daughters received antidotal treatment which had to be repeated in the children. Finally, all recovered completely.Lead intoxication may be easily overlooked due to the unspecific symptoms. It is necessary to think of this rare poisoning which may be caused by old paints, historical ceramics and lead shots, in addition to commercial products imported from abroad.