Lead poisoning

Last updated: Friday, 17, December, 2010
PresentationsAppropriate Tests

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Lead assays have largely superseded assays of 5-aminolaevulinate, porphyrins (urine and red cell) and porphobilinogen synthetase (red cell).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