EC Gastroenterology and Digestive System

Acute colitis is a medical emergency with multiple etiologies, including infections, inflammatory bowel disease, and toxic exposures. This case describes a 42-year-old woman who developed severe acute colitis after ingesting Khôl Beldi, a traditional North African cosmetic known to contain high levels of lead. She presented with profuse bloody diarrhea, abdominal pain, fever, and systemic inflammation. Extensive microbiological and serological tests were negative, while imaging and colonoscopy revealed severe colonic inflammation. Blood lead levels were markedly elevated (142 µg/L), confirming lead-induced colitis. The patient was treated with intravenous hydration, corticosteroids, antibiotics, and chelation therapy with EDTA, leading to significant clinical and biological improvement. This case highlights the importance of considering toxic exposures in cases of acute colitis of unknown origin, particularly in regions where traditional remedies are commonly used.

 Keywords: Acute Colitis; Lead Intoxication; Khôl Beldi; Toxic Colitis; Gastrointestinal Toxicity

1. Flora SJ., et al. “Toxicity of lead: A review with recent updates”. Interdisciplinary Toxicology 2 (2012): 47-58.
2. Hecht EM., et al. “The microbiome and lead toxicity”. Current Environmental Health Reports 4 (2021): 123-134.
3. Needleman HL. “Lead poisoning”. Annual Review of Medicine 55 (2004): 209-222.
4. Shukla N., et al. “Lead-induced colitis: A rare case report”. Indian Journal of Gastroenterology 2 (2015): 157-160.
5. World Health Organization (WHO). “Lead exposure and health outcomes”. WHO Guidelines (2019).
6. Centers for Disease Control and Prevention (CDC). “Lead toxicity overview” (2020).
7. Goyer RA., et al. “Chelation therapy for lead poisoning”. Journal of Medical Toxicology 1 (2013): 64-74.
8. Rabinowitz MB., et al. “Gastrointestinal effects of lead poisoning”. Journal of Toxicology: Clinical Toxicology 3 (2010): 259-264.