Lead poisoning natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aksiniya K. Stevasarova, MD
Overview
If left untreated, 100% of patients with [lead poisoning] may progress to develop seizures, unconsciousness and death.
Natural History, Complications, and Prognosis
Natural History
- Symptoms of acute lead poisoning usually develop in the first 3 year of life, and start with symptoms such as pain, muscle weakness, numbness and tingling, and, rarely, symptoms associated with encephalitis.[1] Abdominal pain, nausea, vomiting, diarrhea, and constipation are other acute symptoms.[2] Lead's effects on the mouth include astringency and a metallic taste.[2] Gastrointestinal problems, such as constipation, diarrhea, poor appetite, or weight loss, are common in acute poisoning. Absorption of large amounts of lead over a short time can cause circulatoryshock due to loss of water from the gastrointestinal tract.[2] Hemolysis due to acute poisoning can cause anemia and hemoglobinuria.[2] Damage to kidneys can cause changes in urination such as oliguria.[2]
Complications
- Common complications of lead poisoning include:
Central nervous system and neuromuscular symptoms usually result from intense exposure, while gastrointestinal symptoms usually result from exposure over longer periods.[2] Signs of chronic exposure include loss of short-term memory or concentration, depression, nausea, abdominal pain, loss of coordination, and numbness and tingling in the extremities.[3][unreliable medical source?] Fatigue, problems with sleep, headaches, stupor, slurred speech, and anemia are also found in chronic lead poisoning.[1] A "lead hue" of the skin with pallor and/or lividity is another feature.[4][5] A blue line along the gum with bluish black edging to the teeth, known as a Burton line, is another indication of chronic lead poisoning.[6] Children with chronic poisoning may refuse to play or may have hyperkinetic or aggressive behavior disorders.[1] Visual disturbance may present with gradually progressing blurred vision as a result of central scotoma, caused by toxic optic neuritis.[7]
Prognosis
- Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
- Depending on the extent of the [tumor/disease progression/etc.] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
- The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
- [Subtype of disease/malignancy] is associated with the most favorable prognosis.
- The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.
References
- ↑ 1.0 1.1 1.2
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5
- ↑
- ↑ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0. :859
- ↑ El Safoury, OmarSoliman; Abd El Fatah, DinaSabry; Ibrahim, Magdy (2009). "Treatment of periocular hyperpigmentation due to lead of kohl (surma) by penicillamine: A single group non-randomized clinical trial". Indian Journal of Dermatology. 54 (4): 361. doi:10.4103/0019-5154.57614. ISSN 0019-5154. PMID 20101339.
- ↑ Rambousek (2008) p.177
- ↑ Fintak, David R. (30 January 2007). "Wills Eye Resident Case Series". Archived from the original on 14 July 2014.