Lead poisoning (toxicity)

Description Lead poisoning or t...

Description

Lead poisoning or toxicity most commonly occurs over time. The ingested amount of lead is not cleared from the body and accumulates. The lead causes anemia, decreased IQ, abdominal pain, constipation, and kidney damage. Children are more susceptible, and exposure is often from old peeling paint. Other types of exposure are from hobbies and toys. In adults, exposure may occur among those who hunt with lead bullets or use them regularly at a firing range.

Symptoms

Abdominal pain, poor attention and difficulty learning, hearing problems, constipation, anemia (low red blood cell count), irritability, aggression, headaches, problems sleeping, poor appetite, and numbness. High levels can cause vomiting, imbalance, weakness, seizures and coma.

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical exam will be performed. Blood tests will be performed to determine organ damage (such as tests of kidney function and blood counts for anemia), and to establish a lead level. An X-ray of the abdomen may be able to identify the lead after an acute ingestion.

Tests:
Pregnancy (BHCG) test, Complete blood count (CBC), Comprehensive metabolic panel (CMP), Urinalysis (UA), X-ray

Other Specific Tests: Lead level, Uric acid, Free erythrocyte protoporphorin level

Specialists:
Medical Toxicology

Treatment

Treatment includes intravenous fluids and, in an acute ingestion, cleaning the bowel of all contents with gastric lavage ("pumping the stomach") and whole bowel irrigation. Chelation therapy is a treatment option when blood levels are high and/or significant symptoms are present. This treatment binds the lead and allows it to be excreted from the body. The timing and type of chelation treatment depends on the symptoms and severity of toxicity. Identifying the source of lead and preventing re-exposure are important parts of evaluation and treatment.