Reporting on Adverse Clinical Events

Abstract

A 64-year-old male patient developed progressive cramping abdominal pain, malaise, nausea, and vomiting approximately 5 months after selfstarting 7 herbal medications for the treatment of diabetes. The only other concurrent medication noted in the report was saxagliptin. Examination revealed elevated blood pressure and abdominal pain with no guarding. Abnormal laboratory values indicated hypochromic normocytic anemia and mild renal dysfunction. Blood lead levels were 6.8 mmol/L. The herbal medications were analyzed revealing lead content that would have resulted in total lead exposure of 52.84 mg/day and a cumulative total lead exposure of 9.64 g. Oral chelation therapy was initiated with dimercaptosuccinic acid (10 mg/kg 3 times a day for 5 days and then twice a day for 2 weeks). The patient was discharged with follow-up monitoring. After treatment with a total of 2 courses of dimercaptosuccinic acid (19 days each), the blood lead level decreased to 1.4 mmol/L. The authors concluded that this patient experienced lead poisoning as a result of exposure from herbal medications. Ayurvedic Medications [Herbal Medications] Sadler M & Bell S (M Sadler, PO Box 105-952, Auckland City 1143, New Zealand; e-mail: matthew.sadler@doctors.net.uk) Ayurvedic plumbism. Intern Med J 47:823–825 (Jul) 2017