Abstract
Although the majority of published cases of lead poisoning come from occupational exposures, some traditional remedies may also contain toxic amounts of lead. Ayurveda is a system of traditional medicine that is native to India and is used in many parts of world as an alternative to standard treatment regimens. Here, we report the case of a 58-year-old woman who presented with abdominal pain, anemia, liver function abnormalities, and an elevated blood lead level. The patient was found to have been taking the Ayurvedic medicine Jambrulin prior to presentation. Chemical analysis of the medication showed high levels of lead. Following treatment with an oral chelating agent, the patient's symptoms resolved and laboratory abnormalities normalized. This case highlights the need for increased awareness that some Ayurvedic medicines may contain potentially harmful levels of heavy metals and people who use them are at risk of developing associated toxicities.
Highlights
Ayurvedic medicine is a traditional system native to India [1]
Review of the peripheral blood smear demonstrated normochromic, normocytic anemia with extensive coarse basophilic stippling of the erythrocytes (Figure 1). This triggered a screening for heavy metals, which revealed an elevated blood lead level (BLL) of 102 μ g/dL
Exposure to lead through ingestion or inhalation can occur from contaminated air, water, soil, food, and consumer products
Summary
Ayurvedic medicine is a traditional system native to India [1]. This system stresses the use of natural plantbased medicines, and minerals including sulfur, arsenic, lead, copper and gold are often added to formulations with the belief that these metals are essential components of vital molecules within the human body. Case presentation A 58-year-old woman from India residing in the U.S presented to the emergency department with a 10-day history of progressively worsening post-prandial lower abdominal pain and nausea accompanied by non-bilious and non-bloody vomiting Review of the peripheral blood smear demonstrated normochromic, normocytic anemia with extensive coarse basophilic stippling of the erythrocytes (Figure 1) This triggered a screening for heavy metals, which revealed an elevated blood lead level (BLL) of 102 μ g/dL (normal < 10 μ g/dL). The patient had obtained the medication from Unjha pharmacy through a family member in India She had been taking 2 pills daily over a period of 5 to 6 weeks in an effort to enhance control of her diabetes.
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