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Intercurrent Infection in Lead Poisoning

HENRIETTA K. SACHS, MD
Am J Dis Child. 1978;132(3):315-316. doi:10.1001/archpedi.1978.02120280099021.
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Recurrence of plumbism due to mobilization of stored lead has been an unquestioned concept.1 Demineralization of bone is thought to occur when acidosis is induced by fever, causing an increase in circulating lead. Even patients who have been treated with chelating agents are believed at risk during intercurrent infection until residual soft tissue lead is transferred to bone and ceases, after a year, to be available.2-4

In 29 children with normal lead values studied by Oleske, examination of trace metals in response to acute infection revealed a rise in copper and fall in zinc, but no change in blood lead concentration.5 The possibility that blood lead does not rise during infection even in children who were lead poisoned was suggested during a current study of 104 patients recalled for evaluation whose maximum blood lead concentration two to ten years earlier ranged from 100 to 471 μg.

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