Sickle cell disease and plumbism in children

Abstract

Childhood lead poisoning is common, affects multiple organs and is preventable. Co-existence of plumbism and sickle cell disease (SCD) is uncommon, with major overlap in signs and symptoms. We describe a patient with SCD and plumbism. Dysfunctional eating patterns may cause ingestion and increased absorption of lead in these patients. Routine screening for pica and other dysfunctional eating habits with appropriate behavioral interventions is emphasized. Annual screening for lead in patients with SCD of all ages (1-21years) and supplementation of micronutrients like zinc and iron in deficient cases may help prevent plumbism in these patients.

Clinical Factors Associated With Morbidity and Mortality in Patients Admitted with Sickle Cell Disease

“…Dactylitis and splenic sequestration are common in children under five years of age, while strokes and leg ulcerations are common during adolescence and chronic organ damage is most common in adulthood (5,6). Within genotypes, the manifestation of the disease is highly variable (7,8).…”

Pantoea species sepsis associated with sickle cell crisis in a pregnant woman with a history of pica

“…It is tempting to speculate that as a compromised host with sickle cell disease, functional asplenia, and pregnancy, she was at increased risk for serious infection in general, and she became heavily colonized with Pantoea sp secondarily to her prodigious potting soil ingestion and house plant exposure. Her pica may have been driven by emotional factors or chronic anemia [15,16]. The organism may have attained bloodstream access by gut translocation or by cutaneous contamination of her central catheter during hospitalization.…”

Lead Toxicity in the Pediatric Patient with Sickle Cell Disease: Unique Risks and Management

“…Data from review articles suggest annual BLL screening of children of all ages with SCD due to the uniquely high prevalence of dysfunctional eating patterns that persist into older age. 7…”

“…Diagnoses of VOC and lead toxicity are both serious, but delays in diagnosing lead toxicity can progress rapidly to lead encephalopathy, especially in children. 7 Early vague complaints followed by rapid deterioration are common in SCD patients with lead toxicity. 7 Table 2 summarizes key differences between lead toxicity in the general and SCD populations.…”

“…7 Early vague complaints followed by rapid deterioration are common in SCD patients with lead toxicity. 7 Table 2 summarizes key differences between lead toxicity in the general and SCD populations.…”