History and admission findings: 3 years ago, a 63-year-old man underwent laparotomia due to clinical signs of acute abdominal pain. The anemia was treated with erythrocyte concentrates. Several weeks before the current admission to our outpatient department, the patient was again hospitalized because of acute abdominal pain and anemia. The patient was then transferred to the University clinic for further medical tests.
Investigations: In addition to a normocytic anemia, a secondary porphyria was found. Further medical tests demonstrated lead poisoning.
Diagnosis, treatment and course: Initially, the cause of the lead poisoning remained unclear because the patient had reported neither an occuppational nor an environmental exposure to lead. Finally, a prescription-prepared ointment was evaluated, which the patient had applied to his feet and lips over the past 3 years.
Conclusion: Lead poisoning can be found outside the realm of occupational exposure; therefore, the knowledge of lead poisoning is still important.