1 Combined chronic lead and arsenic poisoning was diagnosed in a 33-year-old Korean woman following consumption of a Korean herbal medicine prescribed for haemorrhoids.
2 The patient had malaise, severe difficulty walking, arthralgia, oedema and abdominal pain with diarrhoea.
3 Investigation showed anaemia with basophilic stippling, fragmentation and a raised reticulocyte count.
4 Raised blood and urine lead levels and urine arsenic levels were found.
5 Analysis of the herbal medicine revealed a high lead and arsenic content.
6 Treatment with the newer chelating agent 2,3-dimercaptosuccinic acid was successful, with no detectable side-effects.
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