Abstract Details

Title Peripheral Neuropathy Following Hair Dye Exposure: A Case Report

Topic Peripheral Nerve

Presentation(s) P07 - (-)

Poster/Presentation
Number 052

Objective

Background BACKGROUND: Though lead intoxication has decreased in developed countries, a hidden source of lead is being increasingly reported in cosmetic products.

Design/Methods DESIGN/METHODS: Case report.

Results RESULTS: A 52-year-old gentleman presented with numbness and paresthesias in both hands and feet. His medical history is significant for a history of alcohol abuse though he stopped drinking more than six months prior to symptom onset. His examination revealed sensory loss in a stocking-glove distribution. Nerve-conduction-studies (NCS) and needle-electromyography (EMG) performed at the time of presentation revealed a symmetric, length-dependent and predominantly axonal polyneuropathy. Laboratory workup was unremarkable except for an elevated blood lead level of 17.3mcg/dL (normal 0.0-4.9mcg/dl). He admitted to using a hair dye containing lead acetate to color his beard and hair for at least 6 months before symptom onset. No other systemic manifestations of lead intoxication were present. After discontinuing the use of this dye, his lead levels trended down to 8.9mcg/dL after 3 months and normalized on his 6 month followup. He reported near complete resolution of the numbness and paresthesias which matched his exam findings. A follow up NCS/EMG was also normal.

Conclusions CONCLUSIONS: Chronic lead toxicity typically presents with a length-dependent, mainly sensory, axonal polyneuropathy. Our patient had short-term exposure, with lead levels much lower than what is usually considered toxic (less than 40mcg/dL) but still developed a sensory axonal polyneuropathy. We postulate that by dying the beard increases the risk of oral absorption of lead, which might contribute to the patient's presentation. Lead is present in some cosmetic products. Our case indicates a possible relation between the route of exposure (oral absorption as dying the beard) and the clinical presentation even at levels considered to be 'safe'.

Authors/Disclosures
Wissam G. Deeb, MD (UMass Memorial) PRESENTER	Dr. Deeb has a non-compensated relationship as a Board member with Davis Phinney Foundation that is relevant to AAN interests or activities.
David Cachia, MD	Dr. Cachia has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for RedHill Biopharma Ltd. Dr. Cachia has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GuidePoint Global LLC. Dr. Cachia has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Dedham Group. Dr. Cachia has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Massachusetts Neurological Society.
Colin Quinn, MD (University of Pennsylvania)	Dr. Quinn has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. Dr. Quinn has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abcuro. Dr. Quinn has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Voyager Therapeutics. Dr. Quinn has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Catalyst Pharmaceuticals.
Johnny Salameh, MD, FAAN	Dr. Salameh has nothing to disclose.
Bruce R. Korf, MD (University of Alabama At Birmingham)	Dr. Korf has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for SpringWorks Pharmaceuticals. Dr. Korf has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Healx. Dr. Korf has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Recursion. Dr. Korf has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genome Medical. Dr. Korf has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Infixion. Dr. Korf has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Journal of Human Genetics. Dr. Korf has stock in Genome Medical. The institution of Dr. Korf has received research support from NIH. The institution of Dr. Korf has received research support from Department of Defense. The institution of Dr. Korf has received research support from Children's Tumor Foundation. Dr. Korf has received publishing royalties from a publication relating to health care. Dr. Korf has received publishing royalties from a publication relating to health care. Dr. Korf has received publishing royalties from a publication relating to health care.

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