Severe lead poisoning due to exposure to ayurvedic herbal medicine

Gabriella Cericola^1*Alexander Puzik1²Sarah Salou²Ayami Yoshimi²Charlotte Niemeyer²Tobias Feuchtinger²Fred Henretig³Luke Yip⁴Siegfried Krell⁵Simone Hettmer^2,6

• ¹University of Freiburg Medical Center, Freiburg, Germany
• ²Universitatsklinikum Freiburg, Freiburg, Germany
• ³The Children's Hospital of Philadelphia Department of Pediatrics, Philadelphia, United States
• ⁴US Centers for Disease Control and Prevention Research Centers, Atlanta, United States
• ⁵Medizinisches Labor Bremen, Bremen, Germany
• ⁶Universitatsklinikum Halle Saale, Halle (Saale), Germany

Introduction: Lead is an environmental toxin that may cause severe damage to vital organs including the brain, kidneys, liver, and bones. Children are particularly susceptible due to higher rates of gastrointestinal absorption and detrimental effects of lead on their developing nervous systems. Methods: This report highlights the case of a 4-year-old boy with severe lead poisoning resulting from prolonged exposure to ayurvedic herbal supplements. Results: The child was initially admitted with anemia, arterial hypertension, abdominal pain, and mild neurological impairment. His blood smear revealed pronounced basophilic stippling of erythrocytes. His venous blood lead level (BLL) was markedly elevated at 123 μg/dL. Detailed review of his history uncovered that he had been ingesting an ayurvedic herbal medicine for asthma. He received chelation therapy with 2,3-dimercapto-1-propanesulfonic acid and calcium disodium EDTA, resulting in rapid resolution of symptoms and gradually decreasing BLLs. Conclusions: The case is a striking example of the significant health risks due to heavy metal contamination in ayurveda products. Better strategies to control the composition of ayurvedic products and educate families about their possible heavy metal contamination are essential to reduce the risk of lead poisoning. (186 words)