Chronic anemia and abdominal pain caused by lead poisoning

History and admission findings: 3 years ago, a 63-year-old man underwent la parotomia due to clinical signs of acute abdominal pain, The anemia was tre ated with erythrocyte concentrates. Several weeks before the current admiss ion to our outpatient department, the patient was again hospitalized becaus e of acute abdominal pain and anemia. The patient was then transferred to t he 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 remainedunclear because the patient had reported neither an occuppational nor an environmental exposure to lead. Finally, a prescription-prepared oin tment was evaluated, which the patient had applied to his feet and lips ove r the past 3 years. Conclusion: Lead poisoning can be found outside the realm of occupational e xposure.