Lead poisoning in children: a case report

Jouhadi, Z.; Bensabbahia, Dalal; Chafiq, Fouad; Oukkache, Bouchra; Guebessi, N. Bennani; Abdellah, El Abidi; Najib, J.

doi:10.11604/pamj.2016.24.316.10352

Cited by 9 publications

(4 citation statements)

References 7 publications

(16 reference statements)

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“…Our patient also presented with renal tubular damage in the form of proteinuria, which may be a presenting symptom [ 2 ]. However, in our case, “lead colic” - constipation, abdominal pain, and vomiting, which is a common feature of severe lead poisoning, was absent [ 2 , 5 ]. As such, direct overt encephalopathy is an unusual presentation of lead poisoning [ 2 , 6 - 8 ].…”

Section: Discussionmentioning

confidence: 92%

Reversal of Acute Lead Encephalopathy in a Child

Keshri¹,

Goel²,

Garg³

2021

Cureus

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Lead poisoning, fairly common in the 20th century, has decreased drastically in the last decade. Severe lead poisoning in the form of encephalopathy has a fatality rate of 28% to 45% and neurological sequelae in about 82%. We present the management of a case of lead encephalopathy that recovered without any significant neurological sequelae in a resource-limited setting. A previously healthy seven-year-old boy presented with complaints of falling unconscious on the ground while playing, followed by multiple episodes of seizures, vomiting, and altered sensorium. The patient had pallor, Glasgow coma score of E2V3M3, with features of raised intracranial pressure. Lead poisoning was suspected as the patient had four months of exposure to a battery recycling factory. Management of seizures and raised intracranial pressure was done. X-ray long bones showed lead lines at the metaphysis. Blood lead levels were highly elevated (139.96 mcg/dL). Investigations revealed iron deficiency anemia, vitamin D deficiency, and renal tubular injury in the form of proteinuria. D-penicillamine with supplements was started due to unavailability of other chelating agents. Encephalopathy improved, but patient had psychiatric symptoms of hallucinations and delusions. On the 12th day, CaNa 2 EDTA was started, which resulted in significant improvement in the psychiatric symptoms.The patient had near-complete recovery in another one month, the patient being able to read, write, recite and speak as the pre-illness state. In conclusion, lead poisoning remains a significant health problem even today. Early recognition and management are of paramount importance in its outcome.

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Section: Discussionmentioning

confidence: 92%

Reversal of Acute Lead Encephalopathy in a Child

Keshri¹,

Goel²,

Garg³

2021

Cureus

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“…The patient's blood lead level was much higher than her mother's, possibly because lead is more easily stored in children than in adults. Another reason is that lead is distributed differently in their bodies; 95% of lead is stored in bones in adults ( 9 ), while only 70% is stored in bones in children ( 10 ).…”

Section: Discussionmentioning

confidence: 99%

Lead poisoning in a 6-month-old infant: a case report

Duan

Yan

Gao

et al. 2023

Front. Public Health

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BackgroundLead is a toxic element of the environment that leads to major complications once it enters the blood stream, affecting multiple organs and systems of the body.MethodsWe present a case of a 6-month-old female infant diagnosed with lead poisoning after presenting for routine child health care. The child's mother denied that the infant had a history of exposure to lead-containing substances. After a month of calcium supplementation, the patient's blood lead level remained elevated. We then tested the blood lead level of the mother and father. The results showed that the blood lead level of the mother was 77.0 μg/L and that of the father was 36.9 μg/L. The high blood lead level of the mother attracted our attention. We found that the mother had been using an external traditional Chinese medicine, Hu Wang Fen, which contains lead. After the mother's discontinuation of use of the traditional medicine, the child was treated with symptomatic treatment and chelation therapy. Subsequently, the patient's blood lead level decreased significantly.ResultsLead toxicity can be a life-threatening problem because of its potential for severe complications. In children, there is no safe blood lead level, and the toxic effects of lead can be prevented by the awareness and avoidance of traditional Chinese medicines that may contain lead.ConclusionEven though the diagnosis of lead poisoning remains difficult in children, it must be taken into consideration by the clinician when treating a child using traditional Chinese medicines.

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“…2 Further cases have since been reported, and in the last 10 years, we found four cases of children with pica who presented with lead poisoning: two related to paint peelings, one from a battery and one from soil. [3][4][5][6] In one of the cases, lead toxicity from paint chippings was also initially misdiagnosed as a viral illness until the child presented 2 days later with worsening symptoms and fluctuating consciousness. 6 Children absorb up to 50% of ingested lead, in contrast with adults, who typically absorb less than 10%.…”

Section: Discussionmentioning

confidence: 99%

Lead in a case of encephalopathy

Talbot¹,

Lippiatt

Tantry

2018

BMJ Case Reports

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A 2-year-old boy with a history of pica was admitted with vomiting and treated overnight for viral tonsillitis. A week later, he presented with a prolonged afebrile seizure and required intubation and ventilation. Antibiotics and acyclovir were started. Despite extensive investigations including MRI head, no cause was identified. Four days later, he deteriorated with signs of raised intracranial pressure. On day 5, blood lead concentration in the sample collected at admission was reported as grossly elevated, consistent with a diagnosis of severe lead poisoning from ingesting lead-containing paint at the family home. Chelation therapy was started but, unfortunately, he did not make a neurological recovery, and care was withdrawn. A serious case review identified a lack of awareness of lead poisoning and its relation to pica as a root cause. We report this case to share our experience and the importance of considering lead poisoning in children with pica.

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Lead poisoning in children: a case report

Cited by 9 publications

References 7 publications

Reversal of Acute Lead Encephalopathy in a Child

Reversal of Acute Lead Encephalopathy in a Child

Lead poisoning in a 6-month-old infant: a case report

Lead in a case of encephalopathy

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