Lead poisoning

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This refers to disease caused directly by exposure to the element lead (Pb, atomic number 82).

Routes of exposure

• Ingestion
• Inhalation
• Skin exposure

 

Symptoms

Acute poisoning

• Metallic taste 
• Abdominal pain
• Spasmodic abdominal pain (lead colic) 
• Vomiting
• Diarrhoea
• Drowsiness
• Anorexia
• Fatigue
• Muscle weakness
• Headache

Chronic poisoning

• Gastrointestinal disturbances
• Constipation 
• Weakness
• Anorexia
• Insomnia
• Fatigue
• (In children) reduced intelligence
• (In children) learning disabilities
• (In children) behavioural disorders

 

Signs

• Blueish lead line on gums 
• Pallor

Complications

• Renal hypertension
• Convulsions
• Korsakoff's syndrome 
• Encephalopathy
• Nephropathy
• Osteonecrosis
• Shock
• Coma

 

Investigations

• Full blood count : anaemia 
• Urea and electrolytes : impaired renal function
• Abdominal radiographs : passage of ingested metallic lead 

 

Management

• Chelation therapy
• Dimercaptosuccinic acid (DMSA)