We review a case of lead poisoning in a 9-month-old child who presented clinically and radiographically with a posterior fossa mass effect and obstructive hydrocephalus. [ncbi.nlm.nih.gov]

• Fever

  The plaintiff contended that the lead had set off a febrile, or fever-related, seizure. The plaintiff's lawyers used Dr. Peter Kaplan, of Johns Hopkins Bayview, as their expert witness on this theory of the case. [bartlit-beck.com]

  There was no history of fever or symptoms suggestive of raised intracranial pressure, seizures, or focal motor or sensory deficits. The patient denied consumption of alcohol on a regular basis. [jnnp.bmj.com]

  The boy has not had a fever, cough, runny nose, or diarrhea, and he has been producing a normal amount of urine. The patient has not traveled anywhere recently; however, he did receive several new toys from a relative in China about 2 months ago. [medbullets.com]

  Serious reactions to CaNa 2 EDTA include renal insufficiency, proteinuria, microscopic hematuria, fever, and diarrhea. Renal toxicity, which is dose-related, is usually reversible. Adverse effects of CaNa 2 EDTA are probably due to zinc depletion. [msdmanuals.com]

  AEs include local injection site reactions, fever, hypercalcemia, renal insufficiency, and excretion of other essential minerals. 36-38 Succimer is an oral water-soluble dimercaprol analogue associated with fewer AEs than parenteral chelators. [pharmacytimes.com]

• Vomiting

  We report the case of a 7-month-old child who presented with regression of milestones, seizures, altered sensorium, and vomiting. An elder sibling had died of similar complaints. [ncbi.nlm.nih.gov]

  A 68-year-old woman was admitted to our hospital in October 2003, with a 1-month history of fatigue, vomiting, and abdominal pain. Clinical examination revealed hypertension as a new finding but was otherwise normal. [neurology.org]

  Dimercaprol, which can cause vomiting, is given with parenteral or oral fluids. [msdmanuals.com]

  Adverse effects (AEs) include nausea and vomiting (N/V), headache, tachycardia, and leukopenia. [pharmacytimes.com]

  lack of sensory perception, diminished libido, syncope, tremor, irritability, seizure, ataxia, restlessness, and behavioral abnormalities. 1, 2, 6, 7, 9 In severe conditions, cerebral or cerebellar edema may develop; such patients may present with vomiting [ajnr.org]

• Nausea

  […] lead-containing material (e.g. contaminated water, paints, batteries). neuropsychiatric amnesia: short term memory poor concentration ataxia dysarthria sensory loss and paraesthesia in the extremities fatigue, sleep problems headaches depression stupor GI nausea [radiopaedia.org]

  The vast majority of individuals presented with gastrointestinal symptoms including abdominal pain, nausea, vomiting, anorexia and constipation and of them were found to have elevated BLLs. [jhoonline.biomedcentral.com]

  […] extremities Fatigue Irritability Mood disorder Impaired concentration Decline in mental function Loss of hearing Headache Seizures Encephalopathy Loss of memory Muscle pain Muscle coordination problems Gastrointestinal effects Constipation Indigestion Nausea [news-medical.net]

  An initial euphoria was experienced which may be accompanied by hallucinations, delusions, nausea and vomiting and after prolonged inhalation there may be delirium, loss of consciousness and coma and sudden death may occur. [lead.org.au]

  Definition of lead poisoning : chronic intoxication that is produced by the absorption of lead into the system and is characterized especially by fatigue, abdominal pain, nausea, diarrhea, loss of appetite, anemia, a dark line along the gums, and muscular [merriam-webster.com]

• Failure to Thrive

  […] to thrive, and poor weight gain. 11 Transplacental infections generally manifest in infancy with a variety of clinical signs and identifiable serum laboratory abnormalities. 11 Figure 7: A 2-year-old girl receiving treatment for rickets. [healio.com]

• Hypertension

  Called also AIDS encephalopathy. hypernatremic encephalopathy a severe hemorrhagic encephalopathy induced by the hyperosmolarity accompanying hypernatremia and dehydration. hypertensive encephalopathy a complex of cerebral phenomena such as headache, [medical-dictionary.thefreedictionary.com]

  Caution is needed in children with renal impairment, hypertension, or G6PD deficiency. Adverse effects (AEs) include nausea and vomiting (N/V), headache, tachycardia, and leukopenia. [pharmacytimes.com]

  Clinical examination revealed hypertension as a new finding but was otherwise normal. Blood test showed a macrocytic anemia and basophilic stippling of erythrocytes on blood smear. Vitamin B 12 level was 141 nmol/L (normal range [NR] 179 to 660). [neurology.org]

  Hypertensive encephalopathy Hypertensive encephalopathy occurs when blood pressure rises to levels high enough to affect brain function. [emedicinehealth.com]

  Hypertensive encephalopathy: Monitor blood pressure; take antihypertensive medication as directed and do not stop medications or change medication without consulting a doctor. [medicinenet.com]

• Aggressive Behavior

  Signs of repeated lead exposure include: abdominal pain abdominal cramps aggressive behavior constipation sleep problems headaches irritability loss of developmental skills in children loss of appetite fatigue high blood pressure numbness or tingling [healthline.com]

  Chronic lead poisoning in children may cause intellectual disability, seizure disorders, aggressive behavior disorders, developmental regression, chronic abdominal pain, and anemia. [merckmanuals.com]

  Some reports document an increase in depressive disorders, aggressive behavior, and other maladaptive affective disorders in adult patients with lead poisoning. [emedicine.medscape.com]

• Behavior Disorder

  Chronic lead poisoning in children may cause intellectual disability, seizure disorders, aggressive behavior disorders, developmental regression, chronic abdominal pain, and anemia. [merckmanuals.com]

  In addition, the possibility of lead poisoning should be considered in any child with growth failure, developmental delay, hyperactivity, behavior disorders, hearing loss, anemia, etc. [cdc.gov]

• Fussiness

  A 23-month-old female child presented to an emergency department with a mild, nonspecific gastrointestinal illness and periodic fussiness and irritability; the initial physical examination was nonfocal and nondiagnostic. [ncbi.nlm.nih.gov]

• Seizure

  A patient with generalised epileptic seizures, mental and psychotic signs was diagnosed as suffering from lead encephalopathy. [ncbi.nlm.nih.gov]

  Abstract A patient with generalised epileptic seizures, mental and … More [psychoticdisorders.wordpress.com]

  In 1953, Parker, then 2, was brought to the University of Maryland Hospital, after suffering a seizure. He was diagnosed with lead encephalopathy, in which large doses of lead cause seizures, said NL co-counsel Michael D. [bartlit-beck.com]

• Headache

  A 15 year old boy was evaluated in the psychiatric emergency room for the acute onset of "confusion,"insomnia, headache, and shaking of one week's duration. [ncbi.nlm.nih.gov]

  Very high levels of lead in the blood may cause personality changes, headaches, loss of sensation, weakness, a metallic taste in the mouth, uncoordinated walking, digestive problems, and anemia. The diagnosis is based on symptoms and a blood test. [merckmanuals.com]

  […] ingestion or inhalation of lead-containing material (e.g. contaminated water, paints, batteries). neuropsychiatric amnesia: short term memory poor concentration ataxia dysarthria sensory loss and paraesthesia in the extremities fatigue, sleep problems headaches [radiopaedia.org]

  vomiting, ataxia, convulsions, paralysis, stupor, and coma in acute forms, 2, 7, 9, 10 whereas in chronic encephalopathy as in our case, patients present with loss of memory and concentration, depression, disorientation, headache, drowsiness, dizziness [ajnr.org]

• Ataxia

  None of the patients had ataxia. [jnnp.bmj.com]

  Two days later hallucinations, formication and a movement disorder emerged characterized by action tremor, myoclonus, chorea and ataxia. Further history revealed inhalation of gasoline for its euphoric effects. [ncbi.nlm.nih.gov]

  Cerebellar ataxia due to lead encephalopathy in an adult. J Neurol Neurosurg Psychiatry 1998 ; 65 : 797 ↵ Bressler JP, Goldstein GW. Mechanisms of lead neurotoxicity. [ajnr.org]

  Wernicke's encephalopathy a neurological disorder characterized by confusion, apathy, drowsiness, ataxia of gait, nystagmus, and ophthalmoplegia; it is due to thiamine deficiency, usually from chronic alcohol abuse. [medical-dictionary.thefreedictionary.com]

• Confusion

  A 15 year old boy was evaluated in the psychiatric emergency room for the acute onset of "confusion,"insomnia, headache, and shaking of one week's duration. [ncbi.nlm.nih.gov]

  There may be memory loss and confusion, loss of coordination and ataxia with a wobbling gait (walk), and confusion. Non-alcohol related causes can include AIDS, cancer, renal (kidney) dialysis, and hyperthyroidism (thyrotoxicosis). [emedicinehealth.com]

  Wernicke's encephalopathy a neurological disorder characterized by confusion, apathy, drowsiness, ataxia of gait, nystagmus, and ophthalmoplegia; it is due to thiamine deficiency, usually from chronic alcohol abuse. [medical-dictionary.thefreedictionary.com]

  If patients with hypoglycemia are given glucose at the first signs of encephalopathy (for example, irritability, mild confusion), most patients recover completely. [medicinenet.com]

  […] age, and treatment Presentation Symptoms, typically nonspecific, result from lead toxicity abdominal colic (lead colic) nausea vomiting anorexia pain toxicity to renal tubues interstitial nephritis reversible with therapy CNS abnormalities memory loss confusion [medbullets.com]

• Tremor

  Two days later hallucinations, formication and a movement disorder emerged characterized by action tremor, myoclonus, chorea and ataxia. Further history revealed inhalation of gasoline for its euphoric effects. [ncbi.nlm.nih.gov]

  […] progressing to global dementia. hepatic encephalopathy a condition, usually occurring secondary to advanced liver disease, marked by disturbances of consciousness that may progress to deep coma (hepatic coma), psychiatric changes of varying degree, flapping tremor [medical-dictionary.thefreedictionary.com]

  For example, alcohol-induced liver damage (alcoholic cirrhosis) can result in involuntary hand tremors (asterixis), while severe anoxia (lack of oxygen) may result in coma with no movement. [medicinenet.com]

  There was no tremor and no sensory deficits. Deep tendon reflexes were normal. Both plantar reflexes were extensor. There was no neck stiffness. [jnnp.bmj.com]

Further workup revealed severe iron deficiency anemia, and treatment with ferrous sulfate was started after completion of chelation therapy. The family moved out of the home. [consultant360.com]

• Albuminuria

  Substances Disease Registry Definition (CSP) poisoning due to absorption or ingestion of lead or one of its salts; symptoms include loss of appetite, weight loss, colic, constipation, insomnia, headache, dizziness, irritability, moderate hypertension, albuminuria [fpnotebook.com]

The relevant literature concerning the treatment of lead encephalopathy was reviewed during the treatment of this child and preparation of the manuscript. [ncbi.nlm.nih.gov]

Consequently, the prognosis varies from patient to patient and ranges from complete recovery to a poor prognosis that often leads to permanent brain damage or death. [medicinenet.com]

While primary prevention strategies had so far had limited success, the poor prognosis of those severely affected, even with treatment, further emphasised the need for locally based strategies for prevention. [lead.org.au]

[…] erythrocyte fragility Plain radiograph may show bands of increased density at the metaphyses can affect any metaphysis, but the involvement of the proximal fibula and distal ulnar metaphyses is highly suggestive may show bone-in-bone appearance Treatment and prognosis [radiopaedia.org]

[…] causing chronic lead poisoning Epidemiology major risk factor is old homes ( painted or made before 1974 ) with chipped paint occupational exposures workers at battery recycling plants patients with pica may be at increased risk inner city children Prognosis [medbullets.com]

Encephalopathy Prognosis Research continues to assist in understanding brain function and understanding the mechanisms that can cause encephalopathies. [emedicinehealth.com]

The etiologic agent is also the cause of new variant Creutzfeldt-Jakob disease. [medical-dictionary.thefreedictionary.com]

Lead toxicity should always be taken into account in cases of intrahepatic cholestasis with an unknown etiology. [pathopedia-india.com]

For further information on etiology, see Pathophysiology and Etiology of Lead Toxicity. Epidemiology United States statistics Lead poisoning is said to be the most common environmental illness of children in the United States. [emedicine.medscape.com]

[…] lead levels range from 40 to 55 μg per dL [1.95 to 2.65 μmol per L]) >500 μg per dL Excessive, indicating heavy exposure or extreme sensitivity to lead; symptoms likely A most difficult task is to either establish or exclude past lead exposure as the etiology [aafp.org]

The possibility of lead encephalopathy should be considered in the differential diagnosis of children presenting with coma and convulsions of unknown etiology. [cdc.gov]

Adult blood lead epidemiology and surveillance--United States, 1998-2001. MMWR Surveill Summ. 2002;51:1-10. Center for Disease Prevention and Control. Adult blood lead epidemiology and surveillance--United States 2002. MMWR. 2004;53:578. [pharmacytimes.com]

[…] basophilic stippling lead causes toxicity primarily through the generation of reactive oxygen species half-life of ~30 days in the blood, giving it time to diffuse into organs half-life of several decades in the bone, causing chronic lead poisoning Epidemiology [medbullets.com]

Epidemiology United States statistics Lead poisoning is said to be the most common environmental illness of children in the United States. [emedicine.medscape.com]

(iv) There may be diffuse astrocytic proliferation in both the gray and white matter (v) Vascular lesions in the brain are particularly prominent with dilatation and proliferation of capillaries. 2) Kidney: Epidemiological studies have demonstrated a [pathopedia-india.com]

Lead Poisoning, Diagnosis and Treatment Lead Poisoning Pathophysiology Prevention of Lead Poisoning [news-medical.net]

The pathophysiology of the radiographic lead line can be appreciated by understanding the pattern of growth of the long bones. [healio.com]

For further information on etiology, see Pathophysiology and Etiology of Lead Toxicity. Epidemiology United States statistics Lead poisoning is said to be the most common environmental illness of children in the United States. [emedicine.medscape.com]

[…] screened) had first-ever VBLLs of 10–44.9 µg/dL and thus did not require chelation (and are not reported in this analysis), such that the range of exposure of this cohort of children is consistent with the entire clinical and sub-clinical spectrum of lead pathophysiology [journals.plos.org]

CDC Childhood Lead Poisoning Prevention Program, CDC Recommendations for Lead Poisoning Prevention in Newly Arrived Refugee Children. [labtestsonline.it]

The administration of lead containing medications to young infants in Oman is a significant preventable cause of morbidity and mortality having implications, in particular, for physicians involved in the care of Arabic communities. [ncbi.nlm.nih.gov]

Binns HJ, Campbell C, Brown MJ; Centers for Disease Control and Prevention Advisory Committee on Childhood Lead Poisoning Prevention. [consultant360.com]

Centers for Disease Control and Prevention. CDC response to Advisory Committee on Childhood Lead Poisoning Prevention recommendations in “Low Level Lead Exposure Harms Children: A Renewed Call of Primary Prevention.” MMWR. 2012;61:383. [pharmacytimes.com]

Can encephalopathy be prevented? Many cases of encephalopathy can be prevented. The key to prevention is to stop or limit the chance of developing any of the multitudes of causes of encephalopathy. [medicinenet.com]