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Plumbism--a mimicker of common childhood symptoms
V Kalra1, S Gulati, K T Chitralekha
1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi.
Insights
Lead poisoning, or plumbism, is a serious preventable condition affecting children. High blood lead levels were found in all children studied, correlating with common symptoms like colic and anorexia.
Area of Science:
- Pediatrics
- Environmental Health
- Toxicology
Background:
- Lead poisoning (plumbism) is a preventable condition with widespread systemic effects.
- Symptoms can range from subtle childhood issues to severe health consequences, including death.
- It often mimics common pediatric illnesses, potentially delaying diagnosis.
Purpose of the Study:
- To investigate the prevalence and clinical presentation of lead poisoning in children.
- To establish the correlation between blood lead levels and common symptoms in pediatric patients.
- To highlight the need for increased awareness and preventive strategies for plumbism.
Main Methods:
- A prospective study enrolled 46 children with symptoms suggestive of plumbism attending AIIMS.
- Clinical evaluation included detailed history, physical examination, intelligence quotient (IQ), and behavioral assessment.
- Blood lead levels were measured in all participants.
Main Results:
- All children exhibited elevated blood lead levels, with 93% exceeding 20 micrograms/dl and 47.8% over 45 micrograms/dl.
- Common symptoms included recurrent colic, anorexia, vomiting, constipation, growth failure, and pica.
- A statistically significant correlation was observed between blood lead levels and most reported symptoms.
Conclusions:
- Plumbism frequently presents with symptoms that overlap with common childhood illnesses, necessitating thorough investigation.
- Elevated blood lead levels are prevalent in symptomatic children, underscoring the need for diagnostic screening.
- Community awareness, particularly regarding pica, and a multi-pronged approach are crucial for preventing and managing this silent epidemic.
Abstract:
Lead poisoning is a preventable entity that can affect almost every system of the body. Its toxic effects range from subtle common childhood symptoms to even death. In a prospective study forty six children with at least one symptom compatible with plumbism were enrolled after screening patients attending medical services at AIIMS. The work-up included a detailed clinical history and examination including intelligence quotient (IQ) and behaviour. Blood lead levels were estimated in all with due precautions. Their ages ranged from 2.5 to 18 years and M:F ratio was 2:1. The common symptoms included unexplained recurrent colic (39), anorexia (21), sporadic vomiting and constipation (13), pigmented gum lines (11), growth failure (11), history of pica (9) etc. None of the children had acceptable blood lead levels (< 10 micrograms/dl). Ninety three per cent children had levels > 20 micrograms/dl and 47.8% had > 45 micrograms/dl. Statistically significant correlation with blood lead levels was seen with most symptoms. Plumbism can mimic common childhood illnesses and should be investigated in children with a clinically compatible profile. Community awareness with regard to pica reduction may be an important preventive measure. This silent epidemic needs to be aggressively tackled by a multipronged approach.