Citation

Ying XL, Markowitz M, Yan CH. BMC Pediatr. 2018; 18(1): e219.

Affiliation

MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200092, China. yanchonghuai@xinhuamed.com.cn.

Copyright

(Copyright © 2018, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/s12887-018-1193-9

PMID

29980188

Abstract

BACKGROUND: Folk prescriptions continue to be important sources of childhood lead poisoning. Nasal spray folk prescriptions for treating rhinitis has only been reported once previously as a cause of lead poisoning. CASE PRESENTATION: We identified three pediatric cases of severe lead poisoning caused by nasal spray folk medicines prescribed for treating rhinitis. The three patients had similar clinical manifestations including: severe abdominal pain, headache, pale appearance and fatigue. Liver function tests were abnormal. Blood lead levels (BLLs) of the three patients were 91 μg/dL, 91 μg/dL, and 105 μg/dL, respectively. After chelation BLLs decreased. The lead content of the three folk remedies as measured by inductively coupled plasma mass spectrometry (ICP-MS) were 14.8, 22.3, and 33.4%. All the symptoms resolved during a course of chelation therapy. There were no severe side effects of treatment.

CONCLUSIONS: Nasal spray folk prescriptions for treating rhinitis may contain extremely high bio-accessible lead content and are potential sources of lead poisoning. Clinicians should be alert to this possibility especially in those children presenting with multisystem symptoms.

Language: en

Keywords

Child; Folk medicine; Lead poisoning; Nasal spray; Rhinitis