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Neonatal lead poisoning from maternal pica behavior during pregnancy
S Hamilton1, S J Rothenberg, F A Khan
1Charles Drew University of Medicine and Science and UCLA School of Medicine, Los Angeles, California, USA.
Insights
This case study highlights severe lead toxicity in a pregnant woman and her newborn. Prompt treatment with exchange transfusion and dimercaptosuccinic acid led to significant recovery.
Area of Science:
- Environmental Health
- Toxicology
- Maternal-Fetal Medicine
Background:
- Lead toxicity is a growing public health concern due to environmental exposure.
- It can cause severe medical complications, especially in children.
- Pica, an unusual craving, can be a symptom of lead poisoning.
Observation:
- An asymptomatic pregnant Hispanic woman presented with a unique form of pica.
- She was enrolled in a lead screening study during delivery.
- Her blood lead level was 119.4 microg/dL, and her neonate's cord blood lead level was 113.6 microg/dL.
Findings:
- The neonate received an exchange transfusion for severe lead exposure.
- The mother was treated with oral 2,3-dimercaptosuccinic acid (chelation therapy).
- Both mother and infant showed dramatic biochemical improvement after treatment.
Implications:
- This case underscores the importance of lead screening in pregnant women, even if asymptomatic.
- Early detection and intervention are crucial for managing lead toxicity in maternal-fetal dyads.
- Effective chelation therapy can reverse the severe effects of lead poisoning.
Abstract:
Lead toxicity has gained increasing attention in the public media because of its ubiquitous distribution in the environment and the potentially serious medical complications that it can induce, particularly in children. We present a case of an asymptomatic Hispanic woman who exhibited a unique form of pica during her pregnancy. By serendipity, she agreed to enroll into a lead screening study at our medical center when she presented to deliver her child. Her blood lead level was 119.4 microg/dL at delivery, and simultaneous measurement of the neonate's cord blood lead level was 113.6 microg/dL. The infant underwent an exchange transfusion, and the mother was treated with oral 2,3-dimercaptosuccinic acid. Both demonstrated dramatic biochemical improvement.