Lead poisoning natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aksiniya Stevasarova, M.D.

Overview

If left untreated, 100% of patients with [lead poisoning] may progress to develop seizures, unconsciousness and death.

Natural History, Complications, and Prognosis

Natural History

Complications

Central nervous system and neuromuscular symptoms usually result from intense exposure, while gastrointestinal symptoms usually result from exposure over longer periods.[2] Signs of chronic exposure include loss of short-term memory or concentration, depression, nausea], abdominal pain, loss of coordination, and numbness and tingling in the extremities.[3][unreliable medical source?] Fatigue, problems with sleep, headaches, stupor, slurred speech, and anemia are also found in chronic lead poisoning.[1] A "lead hue" of the skin with pallor and/or lividity is another feature of chronic lead poisoning.[4][5] A blue line along the gum with bluish black edging to the teeth, known as a Burton line, is another indication of chronic lead poisoning.[6] Children with chronic poisoning may refuse to play or may have hyperkinetic or aggressive behavior disorders.[1] Visual disturbance may present with gradually progressing blurred vision as a result of central scotoma, caused by toxic optic neuritis.[7]

Prognosis

  • Prognosis is generally related to the extent and duration of lead exposure.[8]

Effects of lead on the physiology of the kidneys and blood are generally reversible; its effects on the central nervous system are not.[9] While peripheral effects in adults often go away when lead exposure ceases, evidence suggests that most of lead's effects on a child's central nervous system are irreversible.[10] Children with lead poisoning may thus have adverse health, cognitive, and behavioral effects that follow them into adulthood.[11]

References

  1. 1.0 1.1 1.2
  2. 2.0 2.1 2.2 2.3 2.4 2.5
  3. James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0. :859
  4. El Safoury, OmarSoliman; Abd El Fatah, DinaSabry; Ibrahim, Magdy (2009). "Treatment of periocular hyperpigmentation due to lead of kohl (surma) by penicillamine: A single group non-randomized clinical trial". Indian Journal of Dermatology. 54 (4): 361. doi:10.4103/0019-5154.57614. ISSN 0019-5154. PMID 20101339.
  5. Rambousek (2008) p.177
  6. Fintak, David R. (30 January 2007). "Wills Eye Resident Case Series". Archived from the original on 14 July 2014.
  7. Chisolm (2004) p. 223
  8. Bellinger, DC (2004). "Lead". Pediatrics. 113 (4 Suppl): 1016–22. doi:10.1542/peds.113.4.S1.1016 (inactive 2018-05-20). PMID 15060194.
  9. Woolf, AD; Goldman, R; Bellinger, DC (2007). "Update on the clinical management of childhood lead poisoning". Pediatric clinics of North America. 54 (2): 271–94, viii. doi:10.1016/j.pcl.2007.01.008. PMID 17448360.

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