Lead poisoning caused by traditional chinese medicine: A case report and literature review

Abstract

Traditional Chinese herbal medicine is widely used for primary health care worldwide as it mostly consists of herbs or herbal extracts known to be safe. However, owing to the intentional or unintentional addition to herbs of lead-containing bases or pastes, lead poisoning from traditional Chinese medicine (TCM) remains a serious issue. We report here a case of lead poisoning caused by long-term use of homemade TCM. A 66-year-old man was admitted for periumbilical pain and constipation. A detailed medication history revealed that the patient had been using homemade TCM for the past 8 months. Screening for heavy metals showed that the patient had a blood lead level of 657 μ g/L and his wife, who was asymptomatic, had a blood lead level of 488 μ g/L. Chemical analysis confirmed a lead concentration of more than 4,000 mg/ kg in the TCM. Both individuals were advised to discontinue the medications and chelation treatment was immediately initiated for the husband. The patient’s periumbilical pain was noticeably relieved after treatment, and blood lead levels returned to normal after three treatment rounds. We also review here the literature to summarize the usual reasons for taking TCM and common features of lead poisoning. Our findings suggest that potential exposure to lead from TCM treatment must be considered when diagnosing unexplained cases of abdominal colic in China. The Chinese health authority should speed up legislation to improve the regulatory framework of TCM, especially regarding small private clinics.