LEAD-INTOXICATION AFTER ADMINISTRATION OF HOUSE SPECIALITIES

Three case of lead intoxication after the administration of ''house sp ecialities'' are illustrated. The lead source could be traced to a lea d-containing ointment in all three patients. Two of them suffered lead intoxication as a result of topical application to the lips, while th e third had ingested the ointment orally. Clinical signs, diagnosis an d therapy of lead poisoning are described in the light of the case rep orts. The patients were treated with various drugs (N-acetylcysteine a nd the complex chelators D-penicillamine and 2,3-dimercaptocuccinic ac id (2.3-DMSA). The therapeutic effects were determined on specific lab oratory features in blood and urine. N-acetylcystine was not absolutel y confirming in our case. D-penicillamine was effective, but only afte r removal of the source of exposure. Because of its known adverse drug reactions, we preferred the oral lead chelator 2.3-DMSA. Treatment wi th DMSA resulted in a considerable decrease in the blood lead concentr ation and in increase in urinary lead output. The urinary excretion of aminolevulinic acid and coproporphyrin normalized under DMSA. The tre atment was well tolerated and no appreciable side effects were noticed . The literature on metabolism and the characteristic effects of lead intoxication is reviewed and the production, qualities and administrat ion of emplastrum plumbi are-described. All three lead-containing oint ments are summarized by the characterizing term ''house specialities'' . One wonders whether it is justified that there is still control and registration of such ''house specialities'' in Switzerland.