Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • FHx of lead poisoning or parental work with lead
  • cognitive impairment (children)
  • behavioral changes (children)
  • headaches (children)
  • clumsiness and agitation (children)
  • loss of appetite (children)
  • constipation (children)
  • somnolence (children)
  • altered mental state
  • cerebellar signs
  • seizures
  • coma

Other diagnostic factors

  • colicky abdominal pain (adults)
  • hypertension (adults)

Risk factors

  • age 9 to 36 months
  • housing with lead hazards
  • occupational lead exposure
  • lead-contaminated water supplies
  • low socioeconomic status
  • hobbies working with lead
  • pica
  • use of folk medications
  • fetal exposure
  • mineral-deficient and high-fat diets
  • hand-to-mouth activity with toys and other objects
  • working in bullet firing ranges

Diagnostic investigations

1st investigations to order

  • whole-blood lead level
  • CBC
  • serum ferritin
Full details

Investigations to consider

  • 24-hour urine lead with chelation
  • abdominal radiographs
  • nerve conduction studies
Full details

Emerging tests

  • x-ray fluorescence of long bones
  • MRI brain
Full details

Treatment algorithm

ACUTE

Contributors

Authors VIEW ALL

Professor Emeritus of Pediatrics

Medical University of South Carolina

Charleston

SC

Disclosures

JRR declares that he has no competing interests.

Peer reviewers VIEW ALL

NSF International Chair

Department of Environmental Health Sciences

Professor of Environmental Health Sciences, Epidemiology and Internal Medicine

University of Michigan Schools of Public Health and Medicine

Ann Arbor

MI

Disclosures

HH is an author of a reference cited in this monograph. HH has received research funding greater than 6 figures USD.

Chief

Occupational & Environmental Medicine

Cambridge Health Alliance

Associate Professor of Medicine

Harvard Medical School

Associate Professor of Environmental Health Sciences

Harvard School of Public Health

Boston

MA

Disclosures

None disclosed.

Dean

School of Medicine

Campbelltown Campus

University of Western Sydney

Australia

Disclosures

AJ declares that she has no competing interests.

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