Lead poisoning

Presentations

Appropriate Tests

 

Lead, Lead urine; Full blood count, Blood film.

For sub-toxic exposure, or in acute organic lead poisoning, only blood lead is reliable.

If blood lead is normal in a patient with a history of past exposure: urinary lead increment following EDTA infusion (consult pathologist).

Lead assays have largely superseded assays of 5-aminolaevulinate, porphyrins (urine and red cell) and porphobilinogen synthetase (red cell).

In children

 

Acute toxicity

 

  • Abdominal pain

 

  • Haemolytic anaemia

Review Full blood count, Blood film; Reticulocyte count. See Haemolysis for biochemical tests to document the presence of haemolysis.

  • Encephalopathy

 

Subacute/chronic toxicity

 

  • Mental retardation

 

In adults

 

Abdominal pain

 

Lead nephropathy

See Renal tubulo-interstitial disorders

  • Hyperuricaemia

 

Sideroblastic anaemia

 

Neuropathy

 

Ataxia