Lead toxicity - Revision history

Danbot: Add MedicationDose entries for succimer, dimercaprol, EDTA, penicillamine

2026-03-20T21:03:47Z

Add MedicationDose entries for succimer, dimercaprol, EDTA, penicillamine

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 **Adults: 1.5gm/24hrs in 2 divided doses
 **Full course of treatment is 5 days, may be repeated if patient still symptomatic or PbB > 50ug/dl
 ==Disposition==

Rossdonaldson1: /* Evaluation */

2022-07-27T20:20:48Z

Evaluation

← Older revision		Revision as of 20:20, 27 July 2022
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	==Evaluation==		==Evaluation==
			[[File:Lead PoisoningRadio.jpg\|thumb\|X-ray demonstrating the characteristic finding of dense metaphyseal lines in lead poisoning.]]
	[[File:PMC3369416 crg-0006-0243-g03.png\|thumb\|Lead toxicity resulting from an intra-articular retained [[bullet]].]]		[[File:PMC3369416 crg-0006-0243-g03.png\|thumb\|Lead toxicity resulting from an intra-articular retained [[bullet]].]]
	~~[[File:Lead PoisoningRadio.jpg\|thumb\|X-ray demonstrating the characteristic finding of dense metaphyseal lines in lead poisoning.]]~~
	===Work-Up===		===Work-Up===
	*Lead level		*Lead level

Rossdonaldson1 at 18:53, 27 July 2022

2022-07-27T18:53:57Z

← Older revision		Revision as of 18:53, 27 July 2022
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	==Background==		==Background==
	~~[[File:PMC3369416 crg-0006-0243-g03.png\|thumb\|Lead toxicity resulting from an intra-articular retained [[bullet]].]]~~
	~~[[File:Lead PoisoningRadio.jpg\|thumb\|X-ray demonstrating the characteristic finding of dense metaphyseal lines in lead poisoning.]]~~
	*Stable metallic element (no. 82)		*Stable metallic element (no. 82)
	*Incredible environmental burden secondary to inclusion in paints, fuels, and industrial uses		*Incredible environmental burden secondary to inclusion in paints, fuels, and industrial uses
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	==Evaluation==		==Evaluation==
			[[File:PMC3369416 crg-0006-0243-g03.png\|thumb\|Lead toxicity resulting from an intra-articular retained [[bullet]].]]
			[[File:Lead PoisoningRadio.jpg\|thumb\|X-ray demonstrating the characteristic finding of dense metaphyseal lines in lead poisoning.]]
	===Work-Up===		===Work-Up===
	*Lead level		*Lead level

Rossdonaldson1: /* References */

2022-07-27T18:53:10Z

References

← Older revision		Revision as of 18:53, 27 July 2022
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	**Children retain about 70% while adults only retain about 1%		**Children retain about 70% while adults only retain about 1%

	===~~References~~===		===Sources===
	*Lead paint		*Lead paint
	*Occupational		*Occupational
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	**Eg. Toys imported from China which were coated in lead paints		**Eg. Toys imported from China which were coated in lead paints
	**Eg. plates brought by immigrants from Mexico/South America		**Eg. plates brought by immigrants from Mexico/South America
			*Old gasoline (phased out of gasoline in the 1980s and banned in 1996)
	*~~Phased~~ out of gasoline in the 1980s and banned in 1996

	==Clinical Features==		==Clinical Features==

Rossdonaldson1 at 18:45, 27 July 2022

2022-07-27T18:45:56Z

← Older revision		Revision as of 18:45, 27 July 2022
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	==Background==		==Background==
	[[File:PMC3369416 crg-0006-0243-g03.png\|thumb\|Lead toxicity resulting from an intra-articular retained [[bullet]].]]		[[File:PMC3369416 crg-0006-0243-g03.png\|thumb\|Lead toxicity resulting from an intra-articular retained [[bullet]].]]
			[[File:Lead PoisoningRadio.jpg\|thumb\|X-ray demonstrating the characteristic finding of dense metaphyseal lines in lead poisoning.]]
	*Stable metallic element (no. 82)		*Stable metallic element (no. 82)
	*Incredible environmental burden secondary to inclusion in paints, fuels, and industrial uses		*Incredible environmental burden secondary to inclusion in paints, fuels, and industrial uses

Rossdonaldson1 at 18:42, 27 July 2022

2022-07-27T18:42:43Z

← Older revision		Revision as of 18:42, 27 July 2022
Line 1:		Line 1:
	==Background==		==Background==
			[[File:PMC3369416 crg-0006-0243-g03.png\|thumb\|Lead toxicity resulting from an intra-articular retained [[bullet]].]]
	*Stable metallic element (no. 82)		*Stable metallic element (no. 82)
	*Incredible environmental burden secondary to inclusion in paints, fuels, and industrial uses		*Incredible environmental burden secondary to inclusion in paints, fuels, and industrial uses
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	**Adults: 1.5gm/24hrs in 2 divided doses		**Adults: 1.5gm/24hrs in 2 divided doses
	**Full course of treatment is 5 days, may be repeated if patient still symptomatic or PbB > 50ug/dl		**Full course of treatment is 5 days, may be repeated if patient still symptomatic or PbB > 50ug/dl

			==Disposition==

	==See Also==		==See Also==

Elcatracho: /* See Also */

2021-03-09T06:36:04Z

Elcatracho: /* Nephro */

2021-03-09T06:34:26Z

Nephro

← Older revision		Revision as of 06:34, 9 March 2021
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	=====Nephro=====		=====Nephro=====
	*Impaired [[Vitamin D]] activation		*Impaired [[Vitamin D deficiency\|vitamin D]] activation

	=====Heme=====		=====Heme=====
	*Similar to adults		*Similar to adults

Elcatracho: /* Distribution */

2021-03-09T06:32:42Z

Distribution

← Older revision		Revision as of 06:32, 9 March 2021
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	*After weeks mostly in the bones and teeth		*After weeks mostly in the bones and teeth
	**In adults 94% of total body lead is in the bones and teeth		**In adults 94% of total body lead is in the bones and teeth
	*~~some~~ lead can leave the bones and re-enter blood under certain circumstances		*Some lead can leave the bones and re-enter blood under certain circumstances
	**~~pregnancy~~, periods of breast feeding, fractures, advanced age		**[[Pregnancy]], periods of breast feeding, fractures, advanced age

	=====Metabolism=====		=====Metabolism=====

ClaireLewis at 17:44, 16 October 2019

2019-10-16T17:44:00Z

← Older revision		Revision as of 17:44, 16 October 2019
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	=====Nervous system=====		=====Nervous system=====
	*CNS symptoms predominate		*CNS symptoms predominate
	*Lethargy, fatigue, [[headache]], irritability, memory loss, tremor		*[[Lethargy]], fatigue, [[headache]], irritability, memory loss, [[tremor]]
	*Severe symptoms: [[altered mental status]], coma, [[seizures]], cerebral edema		*Severe symptoms: [[altered mental status]], [[coma]], [[seizures]], cerebral edema
	*PNS toxicity		*PNS toxicity
	**Causes segmental demyelination		**Causes segmental demyelination
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	=====Nephro=====		=====Nephro=====
	*Highest body levels found in proximal tubules after acute exposure		*Highest body levels found in proximal tubules after acute exposure
	**Results in proteinuria, particularly β 2-microglobulin and N-acetylglucosidase.		**Results in [[proteinuria]], particularly β 2-microglobulin and N-acetylglucosidase.
	*associated with slightly decreased GFRs		*associated with slightly decreased GFRs

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	=====Other=====		=====Other=====
	*May also have GI upset, vomiting, ~~constiptation~~, elevated LFTs		*May also have GI upset, [[vomiting]], [[constipation]], elevated [[LFTs]]
	*~~Myalgias~~		*[[Myalgia]]s
	*associated with increased mortality due to cardiovascular disease		*associated with increased mortality due to cardiovascular disease
	*associated with increased blood pressure		*associated with increased blood pressure
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	===Children===		===Children===
	=====Nervous system=====		=====Nervous system=====
	*'''Encephalopathy''' appears at lower levels		*'''[[Encephalopathy]]''' appears at lower levels
	*Symptoms: Irritability, apathy, fatigue, obtundation		*Symptoms: Irritability, apathy, fatigue, [[altered mental status (peds)\|obtundation]]
	*Severe symptoms: Cerebral edema, [[Seizures]]		*Severe symptoms: Cerebral edema, [[Seizures]]
	*Can lead to permanent changes in brain architecture		*Can lead to permanent changes in brain architecture
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	*Lead lines on radiographs		*Lead lines on radiographs
	**Generally correlate with levels above 50μg/dL		**Generally correlate with levels above 50μg/dL
	*Associated with development of dental ~~carries~~ and periodontal bone loss		*Associated with development of [[dental caries]] and periodontal bone loss

	==Differential Diagnosis==		==Differential Diagnosis==
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	===Work-Up===		===Work-Up===
	*Lead level		*Lead level
	*~~U/A~~		*[[UA]]
	*CBC with smear		*CBC with smear
	*Chem 7 and divalents		*Chem 7 and divalents
	*LFTs		*[[LFTs]]
	*'''''DO NOT LP'''''		*'''''DO NOT [[LP]]'''''
	**Cerebral edema may lead to herniation		**Cerebral edema may lead to herniation

← Older revision		Revision as of 06:36, 9 March 2021
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	==See Also==		==See Also==
			*[[Toxicology (main)]]
	*[[Heavy Metals]]		*[[Heavy Metals]]