Chronic Lead Poisoning with Neuropathic presentation like Botulism: A Case Report

Background: Chronic lead poisoning manifestations is often non-specific and may mimic neurologic diseases, gastrointestinal problems, and hematologic disorders. When there is no history of lead exposure, it may be misdiagnosed. Trying to search occult exposure is very important and poisoning could be diagnosed by a simple test of blood lead level. Methods: Here we describe a case of lead poisoning with presentation of acute generalized muscle weakness who was admitted with primary diagnosis of Botulism. We also reviewed the literatures on this topic. Results: The primary diagnosis was food poisoning in further investigation, it revealed that his job is recovering of electronic piece of old computers for about 20 years. Based on recurrent uncontrollable abdominal pain, constipation, generalized weakness, associated with hypochromic microcytic anemia, a highly suspicious to chronic lead toxicity was considered. Patient's blood lead level was 149 mu gr/dL (normal:2-25). Conclusions: Detailed clinical investigation is the first step for identifying rare presentations of lead poisoning cases. The health hazards of lead poisoning are rising due to lack of education regarding the dangers of working with lead. With improving national health policies, we can prevent this chronic and subtle poisoning.