Lead hydroxide

Direct observations: clinical cases, poisoning incidents and other

Administrative data

Endpoint:

direct observations: clinical cases, poisoning incidents and other

Type of information:

other: Case report

Adequacy of study:

other information

Reliability:

4 (not assignable)

Rationale for reliability incl. deficiencies:

other: The study does not give any testing methodology as it reports a human case of lead poisoning Non testing data

Data source

Reference

Reference Type:

publication

Title:

Myelopathia Saturnina Report of a Case

Author:

D.H. Boehme

Year:

1971

Bibliographic source:

Acta Neuropathologica 18, 356-360

Materials and methods

Study type:

poisoning incident

Endpoint addressed:

neurotoxicity

Test guideline

Qualifier:

no guideline followed

Principles of method if other than guideline:

The report describes a case with massive deposition of lead salts around the blood vessels and in the subpial space of the spinal cord, which was unsuspected during life

GLP compliance:

not specified

Method

Type of population:

occupational

Subjects:

- Number of subjects exposed: 1
- Sex: Male
- Age:66 y old
- Race: negro
- Demographic information: USA
- Known diseases: unconsciousness, paralysis,
- Other: Foundry worker, alcoholic

Ethical approval:

not applicable

Route of exposure:

inhalation

oral

Reason of exposure:

unintentional, occupational

Exposure assessment:

not specified

Examinations:

ON ADMISSION
Blood pressure: 140/80
Pulse: 86 min
Temperature: 37.5°C
Tentative diagnosis of cervical fracture
Neurological examination

POST-MORTEM EXAMINATIONS
Spinal cord

Results and discussion

Clinical signs:

On admission: brief spell of unconsciousness, paralysis in both upper extremities, complete anesthesia to touch, pin prick, heat and cold below the level of Th 4-6
1 day after admission: proprioception in fingers absent, unability to flex or extend legs, gastrocnemius and peroneus muscle groups extremely weak, complete anesthesia of the right half of the torso from Th 6 on down and on the left from Th 4 on down, incontinence of bladder and bowel
18 days after admission: respiratory failure, death

Results of examinations:

Spinal cord: greyish-white, very thin, hard and plaque-like deposits of an undetermined material beneath the pia mater; massive deposition between C3 and Th2; large, cystic and slit-like spaces from which the material had largely dropped out; arteriolar and capillary hyalinosis; areas of demyelinisation; chromatolysis of anterior horn cells, simple atrophy, nuclear pyknosis and shifting of the nucleus

Applicant's summary and conclusion

Conclusions:

The nearly reactionless deposition of the material in the spinal cord appears as an interesting anatomical feature in view of the characteristic formation of glia nodules in the brain.
While the lead has most likely reached its site of disposition through the blood stream, the absence of permanent vascular damage could indicate an important role of increased vascular permeability in chronic lead poisoning.