Lead Poisoning Due to Hai GE Fen: The Porphyrin Content of Individual Erythrocytes

Details

• Personal Author:
  Eisinger J ; Kim, Walter S. ; Klitzman S ; Landrigan, Philip J. ; Markowitz SB ; Munshi AA ; Nunez CM
• Description:
  A45-year-old Korean man developed abdominal colic, muscle pain, and fatigue. Following a 3-week hospitalization, acute intermittent porphyria was diagnosed based on the symptoms and a high level of urinary d-aminolevulinic acid (378 umol/L [4.95 mg/dL]). However, discovery of an elevated blood lead level (3.7 umol/L [76 ug/dL]) subsequently led to the correct diagnosis. No occupational source of lead exposure was identified. The patient reported ingesting a Chinese herbal preparation for 4 weeks prior to becoming ill. A public health investigation revealed that the source of lead exposure was hai ge fen (clamshell powder), one of the 36 ingredients of the Chinese herbal medicine. We used fluorescence image-based cytometry to determine the frequency distribution of the zinc protoporphyrin content in circulating red blood cells and found that 70% of the patient's cells contained elevated levels of zinc protoporphyrin, consistent with the duration of lead exposure and effect of lead on heme synthesis. Analysis of zinc protoporphyrin content in circulating red blood cell distributions may be useful in the diagnosis, therapy, and kinetic modeling of lead poisoning. Environmental lead poisoning is best addressed through the close collaboration of clinicians, public health specialists, and laboratory scientists. [Description provided by NIOSH]
• Subjects:
  Diet Environmental Exposure Lead Lead Poisoning Occupational Health Poisoning Safety
• Keywords:
  Biological Effects Environmental Exposure Food Contaminants Lead Poisoning
• ISSN:
  0098-7484
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  271
• Issue:
  12
• NIOSHTIC Number:
  nn:20059912
• Citation:
  JAMA 1994 Mar; 271(12):932-934
• Contact Point Address:
  Dr Markowitz, Mount Sinai School of Medicine, Box 1057, 1 Gustave L. Levy Pl, New York, NY 10029
• CAS Registry Number:
  Lead (CAS RN 7439-92-1)
• Federal Fiscal Year:
  1994
• Performing Organization:
  Mount Sinai School of Medicine, New York
• Peer Reviewed:
  True
• Start Date:
  19920701
• Source Full Name:
  Journal of the American Medical Association
• End Date:
  19970630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:1c5d41b211705c8494a3375d1da03175ec3655d342baf68fef237af5a1b70cb1aacd4b7de5fb1e4bc738ae9f9810c02cabbf4a2b2040da7fefb439418240831a
• Download URL:
  https://stacks.cdc.gov/view/cdc/223966/cdc_223966_DS1.pdf
• File Type:
  [PDF - 1.83 MB ]