171 Case Report: Lead Poisoning Can Be Misdiagnosed as Guillain-barre Syndrome: A Case Report Abbas Aghabiklooei 1 , Maryam Ameri 1* 1. Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran. * Corresponding Author: Maryam Ameri, PhD. Address: Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran. Tel: +98 (912) 7193692 E-mail: maryam.ameri12@yahoo.com Background: Toxic neuropathy is a global health problem afecting many people over the world, annually. Lead Poisoning (LP) represents neurological complaints and neurobehavioral disorders. Therefore, its signifcances, especially its neurological consequences, can be misdiagnosed as other neuropathies like syndromes. Case Presentation: In this case report, we aim at describing a 45-year-old woman with Guillain-Barre-like Syndrome (GBS), who was admitted to the hospital with peripheral neuropathy and complaints of pareshesia in the lower and upper limbs. Sufering from GBS- like syndrome, she incidentally showed opium consumption during the hospitalization and taking her hisory. Serum lead levels were precisely elevated (88.6µg/dL). To assess the neurologic efects, the brain CT, MRI, EMG, and NCV were performed, indicating severe sensory-motor demyelinating polyradiculopathy. The patient was admitted to the hospital again after 2 years with severe radicular pain in the lower and upper limbs and with positive myoclonus and tremor. While treated with plasma exchange and pregabalin at the frs sage of admission, signs were normal and again recurred after 2 years, suggesing the reversibility of the hisological fndings and misdiagnosis. At the second sage, Intravenous Immunoglobulin (IVIG) was prescribed. The patient recovered and was discharged with chelation therapy of CaNa2EDTA for LP. The mos frequent neurological complication induced by LP is severe sensory-motor demyelinating polyradiculopathy and axonal polyneuropathy. But, the clinical examination and the electrophysiological fndings may also sugges a GBS-like syndrome. Conclusion: Any discrepancies in this regard should be reconsidered to confrm LP diagnosis. A B S T R A C T Keywords: Guillain-Barre syndrome, Lead Poisoning, Toxic neuropathy Article info: Received: 17 Jan 2019 Firs Revision: 11 Feb 2019 Accepted: 13 May 2019 Published: 01 Jul 2019 Citation: Aghabiklooei A, Ameri M. Lead Poisoning Can Be Misdiagnosed as Guillain-barre Syndrome: A Case Report . International Journal of Medical Toxicology and Forensic Medicine. 2019; 9(3):171-174. http://dx.doi.org/10.32598/Toxicol - ogy.9.3.171 : http://dx.doi.org/10.32598/Toxicology.9.3.171 Use your device to scan and read the artcle online 1. Introduction ead Poisoning (LP) is manifesed with a variety of symptoms depending on the lead exposure duration [1, 2]. Toxic neuropathies are often misdiagnosed as other disorders because of the lack of available specifc or biological diagnosic tools [3]. The previously published sudy had presented a case of LP in a 5-year-old girl with the signs of anemia, encepha- lopathy, and peripheral neuropathy mimicking GBS [2]. Another sudy had reported a subacute arsenical neuropathy leading to GBS-like and respiratory failure [4]. GBS-like syndrome and encephalopathy have also L Summer 2019, Volume 9, Number 3