Signs and Symptoms of Lead Poisoning

Gastrointestinal Anorexia, abdominal pain, constipation, vomiting, mild jaundice, gingival lead line 

Neurological Ataxia, coma, convulsions, papilledema, headache, peripheral neuritis, wristdrop or footdrop, weakness, paralysis, mild facial or ocular motor nerve paresis, aphonia, laryngeal paralysis, fasciculations, encephalopathy, death 

Renal Albuminuria, cylindruria, porphyrinuria, nephrotic syndrome, renal insufficiency 

Special senses Metallic taste, visual disturbances, optic atrophy, hearing deficits 

Other Facial pallor, anemia, basophilic stippling of red blood cells, muscular wasting, arthralgia, myalgia, hypertension, sterility, gout, miscarriage, stillbirth, inhibition of vitamin D levels, psychiatric symptoms (see Table 8-4) 

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A 56-year-old woman developed the signs and symptoms of lead poisoning after taking an Indian herbal medicine for many years (147). Her blood and urine lead concentrations were 1530 ng/ml and 4785 gg/day. She also had raised liver enzymes. After withdrawal of the remedy and treatment with penicillamine, she made a full recovery. 

Colic is also a symptom of lead poisoning in children. EPA (1986a) has identified a LOAEL of approximately 60-100 pg/dL for children. This value apparently is based on a National Academy of Sciences (NAS 1972) compilation of unpublished data from the patient groups originally discussed in Chisolm (1962, 1965) and Chisolm and Harrison (1956) in which other signs of acute lead poisoning, such as severe constipation, anorexia, and intermittent vomiting, occurred at 60 pg/dL. 

Acute inorganic lead poisoning is uncommon today. It usually results from industrial inhalation of large quantities of lead oxide fumes or, in small children, from ingestion of a large oral dose of lead in the form of lead-based paint chips small objects, eg, toys coated or fabricated from lead or contaminated food or drink. The onset of severe symptoms usually requires several days or weeks of recurrent exposure and manifests as signs and symptoms of encephalopathy or colic. Evidence of hemolytic anemia (or anemia with basophilic stippling if exposure has been subacute), and elevated hepatic aminotransferases may be present. 

If the spill may expose the public to pesticides or pesticide residues, contact public health officials. If anyone is poisoned by contacting the spill or if you suspect that an exposure may lead to poisoning, call the hospital emergency room and provide them with the brand name, active ingredients, and any other labeling information about human health hazards, signs and symptoms of poisoning, and antidotes. 

If this patient has severe acute lead poisoning presenting as signs and symptoms of encephalopathy, treatment should be instituted immediately with... 

Reporting signs and symptoms of health problems. You should immediately notify your employer if you develop signs or symptoms associated with lead poisoning or if you desire medical advice concerning the effects of cur-... 

The alimentary symptoms may be overshadowed by neuromuscular dysfunction, accompanied by signs of motor weakness that may progress to paralysis of the exterior muscles or the wrist (wrist drop), and less often, of the ankles (foot drop). Encephalopathy, the most serious result of lead poisoning, frequendy occurs in children as a result of pica, ie, ingestion of inorganic lead compounds in paint chips this rarely occurs in adults. Nephropathy has also been associated with chronic lead poisoning (147). The toxic effects of lead may be most pronounced on the developing fetus. Consequendy, women must be particulady cautious of lead exposure (148). The U.S. Center for Disease Control recommends a blood level of less than 10 p.m per 100 mL for children. 

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