Peripheral neuropathy in lead‐intoxicated sickle cell patients

Imbus, Charles; Warner, Judith E. A.; Smith, Elaine; Pegelow, Charles H.; Allen, John P.; Powars, Darleen R.

doi:10.1002/mus.880010211

Cited by 15 publications

(3 citation statements)

References 9 publications

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“…Sickle cell disease is prevalent throughout Africa. Previously, an association with peripheral neuropathy affecting children with sickle cell disease who were intoxicated with lead was reported [41]. These children were considered vulnerable to this complication.…”

Section: Recognition Of Etiologiesmentioning

confidence: 98%

Diagnosis and Management of Pediatric Peripheral Neuropathies In Resource-Poor Settings

Wilmshurst

2013

Future Neurol.

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The diagnosis of a peripheral neuropathy in a child who resides in the majority of resource-poor settings is based on the history taken and the clinical examination. The majority of children, unless they demonstrate additional clinical markers, will lack a more definitive diagnosis beyond the label ‘peripheral neuropathy’. The treatable, typically acquired conditions, which are prevalent in these settings, are the priority to identify. This would include neuroinfections, neuroinflammation, toxins and vitamin deficiencies. The management of children with peripheral neuropathies in resource-poor settings must be approached in a different manner to that of more ‘resource-equipped’ settings. Secondary or tertiary centers are scarce, often significant distances away from the patient, and this leads to long delays before access is possible. Most children present to primary healthcare settings and are seen by practitioners with little training in the features suggestive of a peripheral neuropathy. As such, basic aids to assist the healthcare worker in the early recognition and interventions of a child with a peripheral neuropathy are important. In addition, there must be recognition of the child with a rapidly progressive neuropathy where a life-threatening condition is present, and urgent referral to a tertiary setting made wherever possible.

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Section: Recognition Of Etiologiesmentioning

confidence: 98%

Diagnosis and Management of Pediatric Peripheral Neuropathies In Resource-Poor Settings

Wilmshurst

2013

Future Neurol.

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“…Children with sickle cell disease, a condition prevalent throughout the African population, are predisposed to the development of a demyelinating peripheral neuropathy in the setting of lead intoxication. 69 In many resource-poor countries, lead intoxication remains a risk; this is an avoidable exacerbating factor to exclude in children presenting with neuropathy who have sickle cell disease. Chelation therapy was reported to result in improvement of the motor function in the two reported children over a period of months.…”

Section: Malignancies and Reticulosesmentioning

confidence: 99%

“…Chelation therapy was reported to result in improvement of the motor function in the two reported children over a period of months. 69 Sensory neuropathy in patients with sickle cell disease is reported more outside the childhood age range. 159 Connective tissue disorders Rheumatoid arthritis.…”

Section: Sickle Cell Diseasementioning

confidence: 99%

Peripheral nerve disease secondary to systemic conditions in children

Wilmshurst

Ouvrier

Ryan

2019

Ther Adv Neurol Disord

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This review is an overview of systemic conditions that can be associated with peripheral nervous system dysfunction. Children may present with neuropathic symptoms for which, unless considered, a causative systemic condition may not be recognized. Similarly, some systemic conditions may be complicated by comorbid peripheral neuropathies, surveillance for which is indicated. The systemic conditions addressed in this review are critical illness polyneuropathy, chronic renal failure, endocrine disorders such as insulin-dependent diabetes mellitus and multiple endocrine neoplasia type 2b, vitamin deficiency states, malignancies and reticuloses, sickle cell disease, neurofibromatosis, connective tissue disorders, bowel dysmotility and enteropathy, and sarcoidosis. In some disorders presymptomatic screening should be undertaken, while in others there is no benefit from early detection of neuropathy. In children with idiopathic peripheral neuropathies, systemic disorders such as celiac disease should be actively excluded. While management is predominantly focused on symptomatic care through pain control and rehabilitation, some neuropathies improve with effective control of the underlying etiology and in a small proportion a more targeted approach is possible. In conclusion, peripheral neuropathies can be associated with a diverse range of medical conditions and unless actively considered may not be recognized and inadequately managed.

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