Pediatric Lead Toxicity Clinical Presentation

  • Author: Mohamed K Badawy, MD, FAAP; Chief Editor: Timothy E Corden, MD   more...
 
Updated: Nov 8, 2011
 

History

The clinical picture associated with lead poisoning is vague. Symptoms are not specific enough to alarm the physician about lead toxicity. Most cases are currently identified through effective screening of the population at risk. However, patients with lead poisoning frequently have constipation, abdominal pain, and/or anorexia.

Gastrointestinal (GI) symptoms of lead poisoning include the following:

  • Anorexia
  • Vomiting
  • Constipation
  • Abdominal pain

Neurobehavioral changes observed in lead poisoning include the following:

  • Inattentiveness
  • Distractibility
  • Impulsiveness
  • Learning problems

Peripheral nervous system effects (rare in children) associated with lead poisoning include the following:

  • Weakness
  • Peripheral palsies
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Physical Examination

No specific physical signs for lead poisoning are recognized, but patients may exhibit pallor (due to associated anemia) and hyperactivity.

Signs of increased intracranial pressure can include the following:

  • Impaired consciousness
  • Bradycardia
  • Hypertension
  • Respiratory depression
  • Papilledema
  • Coma
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Contributor Information and Disclosures
Author

Mohamed K Badawy, MD, FAAP  Assistant Professor of Emergency Medicine and Pediatrics, University of Texas Southwestern Medical School; Associate Medical Director, Division of Emergency Medicine, Children's Medical Center

Mohamed K Badawy, MD, FAAP is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Gregory P Conners, MD, MPH  Chief, Division of Emergency Medical Services, Children's Mercy Hospital; Vice Chair of Pediatrics for Emergency and Urgent Care; Professor of Pediatrics and Emergency Medicine, University of Missouri-Kansas City School of Medicine

Gregory P Conners, MD, MPH is a member of the following medical societies: Academic Pediatric Association, American Academy of Pediatrics, American College of Emergency Physicians, American Pediatric Society, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Timothy E Corden, MD  Associate Professor of Pediatrics, Co-Director, Policy Core, Injury Research Center, Medical College of Wisconsin; Associate Director, PICU, Children's Hospital of Wisconsin

Timothy E Corden, MD is a member of the following medical societies: American Academy of Pediatrics, Phi Beta Kappa, Society of Critical Care Medicine, and Wisconsin Medical Society

Disclosure: Nothing to disclose.

Additional Contributors

Jeffrey R Tucker, MD Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, University of Connecticut School of Medicine, Connecticut Children's Medical Center

Disclosure: Merck Salary Employment

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

References
  1. Murata K, Iwata T, Dakeishi M, Karita K. Lead Toxicity: Does the Critical Level of Lead Resulting in Adverse Effects Differ between Adults and Children?. J Occup Health. Nov 6 2008;[Medline].

  2. American Academy of Pediatrics Committee on Environmental Health. Lead exposure in children: prevention, detection, and management. Pediatrics. Oct 2005;116(4):1036-46. [Medline]. [Full Text].

  3. American Academy of Pediatrics Committee on Environmental Health. Lead. In: Handbook of Pediatric Environmental Health. American Academy of Pediatrics. Elk Grove, IL: AAP; 1999:131-43.

  4. Canfield RL, Henderson CR Jr, Cory-Slechta DA, et al. Intellectual impairment in children with blood lead concentrations below 10 microg per deciliter. N Engl J Med. Apr 17 2003;348(16):1517-26. [Medline].

  5. Koller K, Brown T, Spurgeon A, Levy L. Recent developments in low-level lead exposure and intellectual impairment in children. Environ Health Perspect. Jun 2004;112(9):987-94. [Medline].

  6. CDC. Preventing Lead Poisoning in Young Children. CDC, United States Department of Health and Human Services:1991. [Full Text].

  7. CDC. Screening Young Children for Lead Poisoning. Guidance for State and Local Public Health Officials. Atlanta, GA: United States Department of Health and Human Services; 1997:[Full Text].

  8. Lanphear BP, Winter NL, Apetz L, Eberly S, Weitzman M. A randomized trial of the effect of dust control on children's blood lead levels. Pediatrics. Jul 1996;98(1):35-40. [Medline].

  9. Lanphear BP, Hornung R, Ho M. Screening housing to prevent lead toxicity in children. Public Health Rep. May-Jun 2005;120(3):305-10. [Medline].

  10. Rogan WJ, Dietrich KN, Ware JH, et al. The effect of chelation therapy with succimer on neuropsychological development in children exposed to lead. N Engl J Med. May 10 2001;344(19):1421-6. [Medline].

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