El plomo metálico de los perdigones puede llegar a absorberse y llegar a la
circulación general. Si el episodio que Ud. menciona sucedió hace 45 años
resulta poco probable que así suceda. Para descartarla sería útil realizarle a
su esposa una medición o dosaje de plomo en sangre. El BAL es uno de los
antídotos empleados en el tratamiento de la intoxicación crónica por plomo (no
el mejor). No entiendo cuál es el uso que se le ha dado en aplicaciones locales.
No encuentro referencias bibliográficas que justifiquen ese uso. Por si UD lee
en inglés le mando referencias de una base de datos (Poisindex) sobre absorción
del plomo a través de perdigones.
LEAD BULLETS (a) Lead intoxication from retained bullets or shrapnel has
been reported. Almost all cases involve lodging of the missile in or near a
joint. Inflammatory changes from development of arthritis or re-injury have
often precipitated symptoms. Synovial fluid is a better solvent for lead than
serum or bone and synovial lead levels can be much higher than blood levels
(Madureira et al, 2002; DeMartini et al, 2001; McQuirter et al, 2001; John &
Boatright, 1999; Farber et al, 1994; Meggs et al, 1994; Aly et al, 1993; Viegas
& Calhoun, 1986; Roberts et al, 1983; DiMaio & Garriott, 1980; Dillman
et al, 1979; Switz et al, 1976; Machly, 1940). (b) Lead poisoning from lead
shot throughout the abdomen occurred two months after a shotgun wound in an 8
year old (Selbst et al, 1986). (c) Ingested bullets or pellets may cause lead
poisoning (Gellert et al, 1993; Lyons & Filston, 1994). Ingestion of lead
shot resulted in a blood lead level of 64 mcg/dL in a four-year-old (Greensher
et al, 1974). (d) A 29-year-old man presented with progressive headache,
weight loss, sharp abdominal pain and a serum lead level of 90 mcg/dL
approximately 3 years after a gunshot wound to the hip (John & Boatright,
1999). (e) Fifteen emergency department patients with radiographic evidence
of retained lead bullets or shrapnel had statistically significant increased
blood lead levels (mean 17 mcg/dL) compared to matched controls (mean 7 mcg/dL).
Time since initial exposure ranged from 1 to 45 years. Actual composition of
retained bullets was not determined (Farrell et al, 1999). |