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Lead poisoning



Lead is a heavy metal, ubiquitous in our environment that has no physiologic role in biological systems. Lead toxicity is a particularly insidious hazard with the potential of causing irreversible health effects associated with chronic toxicity.

Risk Factors

Signs and symptoms

Diagnostic criteria

The clinical presentation varies widely, depending upon the age at exposure, the amount of exposure, and the duration of exposure

New born:

• Born prematurely
• Lower birth weight
• Slowed growth


• Developmental delay
• Learning difficulties
• Irritability
• Loss of appetite
• Weight loss
• Sluggishness
• Fatigue
• Abdominal pain
• Vomiting
• Constipation
• Hearing loss
• Seizures
• Eating things such as paint chips that aren't food (pica)
• Lower IQ
• Anxiety
• Depression
• ADHD Like symptoms


• High blood pressure
• Joint and muscle pain
• Difficulties with memory or concentration
• Headache
• Abdominal pain
• Mood disorders
• Reduced sperm count
• Abnormal sperm
• Miscarriage
• Stillbirth or premature birth in pregnant women
• Anaemia
• Fanconi’s syndrome
• Wrist drop


• Lead blood levels <10 µg/dL
• Free erythrocyte protoporphyrin (FEP) level
• Imaging studies according to presentation,-chest, bones, abdomen etc are ordered as appropriate.


  • Non-pharmacological

    • Remove the source of lead exposure
    • Closely monitor cardiovascular and mental status
    • Maintain an adequate urine output
    • Assess renal and hepatic functions
  • Pharmacological

    Blood Lead levels are 25–40 µg/dL

    • Give D-penicillamine 30-40mg/kg/day PO 1-6months, 2hours before or three hours after meals

    Blood Lead levels are 45–70 µg/dL Chelate the patient using

    • 2,3-Dimercapto-succinic acid (DMSA or succimer) 10mg/kg by deep IM, 8 hourly for 5 days, followed by 10mg/kg 12hourly for 14 days.

    Blood Lead levels of <70 µg/dL and/or encephalopathy

    • Dimercaprol 3mg/kg deep IM 4 hourly for 48 hours followed by 3mg/kg 12 hourly for 10 days
    • Ethylene diamine tetra-acetic acid (CaNa2 EDTA) IV 10mg/kg 8hourly for 5 days


Educate the patient on Dos and Don’ts of poisoning prevention.


• Keep medicines and poison in proper containers and out of reach of children
• Use containers with child resistant caps
• Keep all products in their original container
• Read medicine labels carefully to avoid mistake


• Leave container open
• Transfer products from their origin
• Remove labels from the medicine products
• Put tablets into another containers such as purse or envelope
• Medicine/tablets as sweet
• Take your medicine in front of children as they often copy

Updated on,

14 Novemba 2020 15:00:39


    1. STG
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