환약으로 제조된 한약에 의한 급성 납중독 2례

Two Cases of Lead Poisoning due to Herb Medicinal Pills

  • 최성환 (성균관대학교 의과대학 소아과학교실) ;
  • 박은영 (성균관대학교 의과대학 소아과학교실) ;
  • 심정연 (성균관대학교 의과대학 소아과학교실) ;
  • 김덕수 (성균관대학교 의과대학 소아과학교실) ;
  • 심재원 (성균관대학교 의과대학 소아과학교실) ;
  • 정혜림 (성균관대학교 의과대학 소아과학교실) ;
  • 박문수 (성균관대학교 의과대학 소아과학교실)
  • Choi, Seong Hwan (Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Park, Eun Young (Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Shim, Jung Yeon (Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Deok Soo (Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Shim, Jae Won (Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Jung, Hye Lim (Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Park, Moon Soo (Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
  • 투고 : 2005.05.06
  • 심사 : 2005.08.03
  • 발행 : 2005.09.15

초록

납중독은 가벼운 빈혈에서부터 경련을 동반한 신경장애에 이르기까지 다양한 임상증세를 나타내며, 뼈나 연부조직에 침착되어 비가역적인 장애를 남기므로 임상적으로 중요하다. 특히 소아는 소화관을 통한 흡수율이 높고 배설율이 낮아 납중독의 영향에 예민한데 혈중 농도와 개인차에 따라 심한 복통 및 지능저하, 경련 등의 비가역적인 신경계장애를 남길 수 있어 조기진단 및 치료가 중요하다. 이에 저자들은 살빼는 목적으로 비전문가에게 처방받은 환약으로 제조된 한약을 복용하여 빈혈을 동반한 심한 복통을 주소로 내원한 형제들에게 자칫 출혈성 장질환으로 여기고 지나칠뻔 하였으나 환약복용의 과거력을 단서로 혈중 납농도 및 환약의 납 성분 분석을 통해 확진한 2례를 경험하였기에 이를 문헌 고찰과 함께 보고하는 바이다.

We encountered two children with lead poisoning who were administered herb medicinal pills recommended by their clergyman. These patients presented anemia and severe coliky abdominal pain, but no neurologic symptoms. For this reason, they were initially misdiagnosed with gastrointestinal hemorrhagic disease. However, we got a clue that they took herb medicinal pills. Finally, based on the assay of blood lead level, we made a correct diagnosis of lead poisoning in these patients. These patients underwent chelating therapy. Subsequently, the concentration of blood lead was decreased. Finally, we drew a conclusion that the possibility of lead poisoning must be considered in children who complained of colicky abdominal pain accompanying anemia. Here, we report two pediatric cases of lead poisoning with a review of literature.

키워드

참고문헌

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