Poisoning - Lead Exposure

Victoria Samonte
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Poisoning - Introduction
A 3 year old boy is brought to the emergency department by the paramedics for seizures. The parents narrated that they noticed decrease in the child’s appetite for several days now and that he was not playing as much with his siblings like before. There was no history of previous seizures. He had no signs of infection except for occasional cough. Possibility of head trauma preceding the seizure seemed unlikely by history. He requires 2 IV anticonvulsants to terminate and control the seizure activity.
Although you are contemplating infectious meningitis and managing the child in that line, should toxic ingestion or exposure also be considered as a differential diagnosis in this case?
Lead is a well-known metal used in the manufacturing of various industrial products. It is also, however, a deleterious substance and subtle poison. Table 1 enumerates the known sources of lead.

Table 1: Sources of childhood lead poisoning
Table 1: Sources of childhood lead poisoning
Environmental sources
Antique toys, cribs, or furniture
Contaminated foodstuffs: homegrown vegetables, imported spices, calcium supplements, flour
Cosmetics (eg, kohl, surma, ceruse)
Crafts (ceramic glazes, paint pigments, stained glass–making materials)
Decorative exterior home features (eg, ‘‘pewter-look’’ fencing) Drinking water (especially first morning draw, hot water)
Dust
Folk remedies (eg, litarigio, greta, azarcon, alkohl, bali bali, coral, ghasard, liga, pay-loo-ah, reuda)
Herbal products Imported toys, crayons Imported ceramics or pewter Imported soldered pots, kettles Methamphetamine
Moonshine whiskey
Paint
Plaster, putty
Soil

Exposures from activities
Burning painted wood
Hobbies (eg, target shooting, stained glass making, glazing pottery)
Home renovation
Occupations (eg, auto repair, mining, smelting, demolition, battery manufacture, remodeling, construction, painting, pipe fitting, plumbing, shipbuilding, welding, bridge reconstruction, firing range instructors)
Reference: Woolf AD, Goldman R, Bellinger DC: Update on the Management of Childhood Lead Poisoning. Pediatr Clin N Am. 2007; 54: 271-294.



References
Poisoning - Lead Exposure Poisoning - Lead Exposure 05/11/2016
Clinical Presentation of Lead Poisoning >>
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