Introduction
Lead is a component of paints, gasolines, storage batteries, glass, ceramics and as part of plumbing pipes.
Inorganic lead is absorbed slowly via the
respiratory and gastrointestinal tracts,
but poorly from the skin; organic lead
compounds are volatile & are absorbed from through the skin and respiratory tract.
Absorption via the gastrointestinal tract
is more in children, and is increased in
the presence of low dietary calcium, iron
deficiency and ingestion on an empty stomach.
In the blood stream, most of the lead is
bound to RBC and remainder is
distributed to soft tissues of the brain and kidney.
Clinical features of lead poisoning
The following are the clinical features of lead poisoning:
Acute lead poisoning
- manifest with signs and symptoms of encephalopathy and colic hemolytic anaemia and basophilic stippling may be present
Subacute lead poisoning
- headache, fatigue, intermittent abdominal cramps, myalgia and arthralgia
Chronic lead poisoning
Presentation is muti-systemic:
- Fatigue, myalgia
Central nervous system:
- headache, difficulty in
concentrating, irritability, peripheral neuropathy, and seizures
Gastrointestinal tract
- colics, anorexia, epigastric tenderness, constipation and metallic taste may occur
Diagnosis of lead poisoning
- Blood level of lead
Management:
- Remove from exposure
- Supportive care
- Chelation therapy: Dimercaprol,
penicillamine or Calcium disodium
EDTA