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Lead poisoning in a 10-year-old boy with cyclic vomiting as the first symptom: a case report

Liping Ding1,2, Liyuan Wang1,2, Zhiling Wang1,2

  • 1Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.

Frontiers in Pediatrics
|August 22, 2025
PubMed

Insights

Chronic lead poisoning in children can mimic cyclic vomiting syndrome. Early diagnosis and chelation therapy, such as with dimercaptosuccinic acid (DMSA), significantly improve symptoms and reduce blood lead levels (BLL).

Area of Science:

  • Environmental Health
  • Pediatrics
  • Toxicology

Background:

  • Lead exposure poses significant health risks, especially to children, with potential for long-lasting adverse effects.
  • Cyclic vomiting syndrome (CVS) is a diagnosis of exclusion, often presenting with recurrent vomiting and abdominal pain.

Observation:

  • A 10-year-old boy presented with a 10-month history of recurrent vomiting, growth retardation, vitamin D deficiency, and neurological symptoms.
  • Symptoms were atypical for CVS, prompting further investigation into environmental exposures.
  • History revealed proximity to a lead mining facility, leading to blood lead level (BLL) testing.

Findings:

  • Blood lead level (BLL) was significantly elevated at 382 μg/L, confirming chronic lead poisoning.
  • Chelation therapy with dimercaptosuccinic acid (DMSA) was administered.
  • Post-treatment BLL decreased to 168 µg/L, with marked improvement in vomiting and abdominal pain.

Implications:

  • Pediatric lead poisoning requires consideration in the differential diagnosis of children with unexplained vomiting and neurological symptoms.
  • Prompt diagnosis and intervention are crucial for managing lead toxicity and mitigating long-term health consequences.
  • Environmental factors, such as proximity to mining sites, should be investigated in cases of suspected lead poisoning.
Abstract

Keywords:
cyclic vomitingcyclic vomiting syndromelead poisoningneurological involvementpediatric

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