A 41-year-old man was found to have anemia at a medical checkup. He had anemic palpebral conjunctivae, lower abdominal pain and upper limb tremor. A hematologic examination showed normochromic, normocytic anemia. Peripheral blood smears showed basophilic stippling of erythrocytes (Picture 1). Since he worked in the metal processing industry, lead poisoning was suspected, but a further questionnaire revealed that he had been taking Ayurvedic, a medicine purchased online, as an aphrodisiac. His blood concentration of lead was as high as 240 μg/dL. A capsule was found containing 12 mg of lead, which was 1,000 times the daily intake standard for adults and X-ray opaque (Picture 2). Chelation therapy rapidly improved his symptoms. Ayurvedic is a traditional drug native to India. It is mainly derived from plants and may contain lead, mercury, or arsenic (1). Some reports of lead poisoning due to Ayurvedic have been accepted (2). Online-shopping services make imported medicine more accessible, resulting in potentially serious threats to public health.
Picture 1.
Picture 2.
The authors state that they have no Conflict of Interest (COI).
References
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