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Indian Pediatr 2014;51: 319-320 |
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Lead Poisoning in an infant
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Biplab Maji and Nupur Ganguly
Institute of Child Health, Kolkata, West Bengal, India.
Email:
[email protected]
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An 11-month-old boy weighing 6.75 kg, resident of a
rural area of West Bengal, presented with first episode of generalized
convulsions without fever or any other sign of infection. Hemoglobin was
5.2 g/dL with hypochromic microcytic picture, normal reticulocyte count
(1.8%), low ferritin (19 ng/mL) and a negative direct Coomb’s test.
C-reactive protein was negative; hemoglobin electrophoresis and magnetic
resonance imaging of brain were within normal limits. X-ray of
the wrists showed features of rickets along with prominent lines on the
metaphyseal ends of the long bones and short bones of the hands. Vitamin
D level (13.3 ng/mL) was low. A high blood lead level (121.8 µg/dL) and
urine lead level (44.8 µg/dL) along with metaphyseal lead lines
documented lead poisoning. History revealed that the family had a small
lead battery assembly workshop at home. The child also had pica.
Lead poisoning is unusual nowadays. In a recent study
[1] from Delhi, 12 % of the school children had
high (>10 µg/dL) blood lead levels. This signifies that measures such as
prohibition of leaded pipes, leaded petrol, printing ink are not
sufficient. Cottage industries, for example, silversmiths, print shops,
brass works, small lead battery assembly workshops, radiator repair
workshops, and other such workshops, which are considered as "hot-spots"
should be searched for. Most commonly they are in home settings or where
young children have ready access, creating more chances of exposure to
the children [2], as in our case. An initiative for "hot-spot"
investigations and interventions in cottage industries is thereby
mandated.
References
1. Kalra V, Sahu JK, Bedi P, Pandey RM. Blood lead
levels among school children after phasing-out of leaded petrol in
Delhi, India. Indian J Pediatr. 2013;80:636-40.
2. Suplido ML, Ong CN. Lead exposure among small-scale battery
recyclers, automobile radiator mechanics, and their children in Manila,
the Philippines. Environ Res. 2000;82:231-8.
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