Hepatic morphopathologic findings of lead poisoning in a drug addict: a case report

Joanne Verheij; Jens Voortman; Carin M J van Nieuwkerk; S Vijay A Jarbandhan; Chris J J Mulder; Elisabeth Bloemena

Hepatic morphopathologic findings of lead poisoning in a drug addict: a case report

Joanne Verheij
, Jens Voortman
, Carin M J van Nieuwkerk
, S Vijay A Jarbandhan
, Chris J J Mulder
, Elisabeth Bloemena

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

We describe the case of a 40-year old Iranian man who was admitted to our hospital with severe abdominal pain, abnormal liver function tests and normocytic anemia. Suffering from multiple sclerosis, he was a regular user of opium for pain relief. Basophilic stippling of erythrocytes pointed towards the diagnosis of lead intoxication, the most likely source being contaminated Iranian opium. Serum lead and zinc protoporphyrin levels were strongly elevated. To assess the hepatotoxic effects of lead poisoning a liver biopsy was performed. Pathomorphologic findings of hepatotoxicity, rarely reported in humans, included active hepatitis together with extensive microvesicular and macrovesicular steatosis, hemosiderosis and cholestasis, and a lymphocytic cholangitis. Whilst treated with chelating therapy, liver enzymes returned to normal, suggesting reversibility of the histological findings.

Original language	English
Pages (from-to)	225-7
Number of pages	3
Journal	Journal of gastrointestinal and liver diseases
Volume	18
Issue number	2
Publication status	Published - Jun 2009

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Abdominal Pain/etiology
Adult
Anemia/etiology
Chelating Agents/therapeutic use
Chemical and Drug Induced Liver Injury/etiology
Cholangitis/etiology
Drug Contamination
Fatty Liver/etiology
Hemosiderosis/etiology
Humans
Lead/blood
Lead Poisoning/drug therapy
Liver/drug effects
Male
Opioid-Related Disorders
Opium
Protoporphyrins/blood
Treatment Outcome

Cite this

@article{01a70a95152f4d30a992d6db971d017c,

title = "Hepatic morphopathologic findings of lead poisoning in a drug addict: a case report",

abstract = "We describe the case of a 40-year old Iranian man who was admitted to our hospital with severe abdominal pain, abnormal liver function tests and normocytic anemia. Suffering from multiple sclerosis, he was a regular user of opium for pain relief. Basophilic stippling of erythrocytes pointed towards the diagnosis of lead intoxication, the most likely source being contaminated Iranian opium. Serum lead and zinc protoporphyrin levels were strongly elevated. To assess the hepatotoxic effects of lead poisoning a liver biopsy was performed. Pathomorphologic findings of hepatotoxicity, rarely reported in humans, included active hepatitis together with extensive microvesicular and macrovesicular steatosis, hemosiderosis and cholestasis, and a lymphocytic cholangitis. Whilst treated with chelating therapy, liver enzymes returned to normal, suggesting reversibility of the histological findings.",

keywords = "Abdominal Pain/etiology, Adult, Anemia/etiology, Chelating Agents/therapeutic use, Chemical and Drug Induced Liver Injury/etiology, Cholangitis/etiology, Drug Contamination, Fatty Liver/etiology, Hemosiderosis/etiology, Humans, Lead/blood, Lead Poisoning/drug therapy, Liver/drug effects, Male, Opioid-Related Disorders, Opium, Protoporphyrins/blood, Treatment Outcome",

author = "Joanne Verheij and Jens Voortman and \{van Nieuwkerk\}, \{Carin M J\} and Jarbandhan, \{S Vijay A\} and Mulder, \{Chris J J\} and Elisabeth Bloemena",

year = "2009",

month = jun,

language = "English",

volume = "18",

pages = "225--7",

journal = "Journal of gastrointestinal and liver diseases",

issn = "1841-8724",

publisher = "Romanian Society of Gastroenterology",

number = "2",

}

TY - JOUR

T1 - Hepatic morphopathologic findings of lead poisoning in a drug addict

T2 - a case report

AU - Verheij, Joanne

AU - Voortman, Jens

AU - van Nieuwkerk, Carin M J

AU - Jarbandhan, S Vijay A

AU - Mulder, Chris J J

AU - Bloemena, Elisabeth

PY - 2009/6

Y1 - 2009/6

N2 - We describe the case of a 40-year old Iranian man who was admitted to our hospital with severe abdominal pain, abnormal liver function tests and normocytic anemia. Suffering from multiple sclerosis, he was a regular user of opium for pain relief. Basophilic stippling of erythrocytes pointed towards the diagnosis of lead intoxication, the most likely source being contaminated Iranian opium. Serum lead and zinc protoporphyrin levels were strongly elevated. To assess the hepatotoxic effects of lead poisoning a liver biopsy was performed. Pathomorphologic findings of hepatotoxicity, rarely reported in humans, included active hepatitis together with extensive microvesicular and macrovesicular steatosis, hemosiderosis and cholestasis, and a lymphocytic cholangitis. Whilst treated with chelating therapy, liver enzymes returned to normal, suggesting reversibility of the histological findings.

AB - We describe the case of a 40-year old Iranian man who was admitted to our hospital with severe abdominal pain, abnormal liver function tests and normocytic anemia. Suffering from multiple sclerosis, he was a regular user of opium for pain relief. Basophilic stippling of erythrocytes pointed towards the diagnosis of lead intoxication, the most likely source being contaminated Iranian opium. Serum lead and zinc protoporphyrin levels were strongly elevated. To assess the hepatotoxic effects of lead poisoning a liver biopsy was performed. Pathomorphologic findings of hepatotoxicity, rarely reported in humans, included active hepatitis together with extensive microvesicular and macrovesicular steatosis, hemosiderosis and cholestasis, and a lymphocytic cholangitis. Whilst treated with chelating therapy, liver enzymes returned to normal, suggesting reversibility of the histological findings.

KW - Abdominal Pain/etiology

KW - Adult

KW - Anemia/etiology

KW - Chelating Agents/therapeutic use

KW - Chemical and Drug Induced Liver Injury/etiology

KW - Cholangitis/etiology

KW - Drug Contamination

KW - Fatty Liver/etiology

KW - Hemosiderosis/etiology

KW - Humans

KW - Lead/blood

KW - Lead Poisoning/drug therapy

KW - Liver/drug effects

KW - Male

KW - Opioid-Related Disorders

KW - Opium

KW - Protoporphyrins/blood

KW - Treatment Outcome

M3 - Article

SN - 1841-8724

VL - 18

SP - 225

EP - 227

JO - Journal of gastrointestinal and liver diseases

JF - Journal of gastrointestinal and liver diseases

IS - 2

ER -

Hepatic morphopathologic findings of lead poisoning in a drug addict: a case report

Abstract

UN SDGs

Keywords

Fingerprint

Cite this