0
August 1979, Vol 133, No. 8 >
Article | August 1979

Lead Poisoning Without Encephalopathy:  Effect of Early Diagnosis on Neurologic and Psychologic Salvage FREE

Henrietta K. Sachs, MD; Donald A. McCaughran, PhD; Vita Krall, PhD; Irving H. Rozenfeld, MD; Nillawan Yongsmith, MD
[+] Author Affiliations

Reprint requests to 182 LaPier, Glencoe, IL 60022 (Dr Sachs).


Am J Dis Child. 1979;133(8):786-790. doi:10.1001/archpedi.1979.02130080026003.
Text Size: A A A
Published online
Article
References
Comments

• Medical and psychological status of 166 patients previously treated for lead poisoning and of 22 sibling controls were evaluated. Maximum blood lead levels ranged from 40 to 471 μg/dL. Eighteen patients had definite symptoms, 32 had questionable symptoms, and 116 were asymptomatic. No patients developed seizures, other neurological sequelae, or abnormal nerve conduction velocity. No statistically significant relationship was found between blood lead concentration (PbB) and subsequent intellectual function. The mean IQ of the patient cohort was 87, approximately at the 50th percentile for inner-city schoolchildren in Chicago. Detection prior to encephalopathy and prompt detoxification were effective in preventing or minimizing sequelae despite high PbBs.

(Am J Dis Child 133:786-790, 1979)

REFERENCES

1 +
Byers RK, Lord EE:  Late effects of lead poisoning on mental development . Am J Dis Child 66:471-494, 1943;.
2 +
Perlstein MA, Attala R:  Neurologic sequelae of plumbism in children . Clin Pediatr 5:292-298, 1966;.
3 +
Rudolph AM: Pediatrics , ed 16, Barnett HL, Einhorn AH (eds). New York, Appleton-Century-Crofts Inc, 1977;.
4 +
Sachs HK: Ambulatory treatment of lead poisoning. Read before the Midwest and the Eastern Regional Conferences on Lead Poisoning, American Academy of Pediatrics, Chicago, May 10, 1972, and Wilmington, Del, June 2, 1972.
5 +
Sachs HK, Blanksma LA, Murray EF, et al:  Ambulatory treatment of lead poisoning: Report of 1,155 cases . Pediatrics 46:389-396, 1970;.
6 +
Steinfeld JL:  Medical aspects of childhood lead poisoning . Pediatrics 48:464-468, 1971;.
7 +
Wagman IH, Lesse H:  Maximum conduction velocities of motor fibers of ulnar nerve in human subjects of various ages and sizes . JNeurophysiol 15:235-244, 1952;.
8 +
Johnson EW, Olson KH:  Clinical value of motor nerve conduction velocity determination . JAMA 172:2030-2035, 1960;.
9 +
Mavor J, Libman I:  Motor conduction measurement as a diagnostic tool . Neurology 12:733-744, 1962;.
10 +
Lehmann EL: Nonparametrics: Statistical Methods Based on Ranks . San Francisco, Holden-Day Inc, 1975;.
11 +
Baer RD, Johnson EW:  Motor nerve conduction velocities in normal children . Arch Phys Med 46:698-704, 1965;.
12 +
Gamstorp I:  Normal conduction velocity of ulnar, median and peroneal nerves in infancy, childhood and adolescence . Acta Paediatr Scand , (suppl 146) , 1963;, pp 68-76.
13 +
Chisolm JJ:  The use of chelating agents in the treatment of acute and chronic lead intoxication in childhood . J Pediatr 73:1-38, 1968;.
14 +
Smith HD, Baehner RL, Carney T, et al:  The sequelae of pica with and without lead poisoning: A comparison of the sequelae five or more years later: 1. Clinical and laboratory observations . Am J Dis Child 105:609-616, 1963;.
15 +
Kaufman AS:  Comparison of the performance of matched groups of black children and white children on the Wechsler preschool and primary scale of intelligence . J Consult Clin Psychol 41:186-191, 1973;.
16 +
Shuey AM: The Testing of Negro Intelligence , ed 2. New York, Social Science Press, 1966;.
17 +
Results of the 1969-1970 City-Wide Testing Program . Chicago, Chicago Public Schools, Chicago Board of Education, 1971;.
18 +
Report on the City-Wide Testing Program in Reading Comprehension, 1974-1975 . Chicago, Chicago Public Schools, Department of Research and Evaluation, 1975;.
19 +
Havighurst RJ: The Public Schools of Chicago . Chicago, Board of Education, City of Chicago, 1964;.
20 +
De la Burde B, Choate MS:  Early asymptomatic lead exposure and development at school age . J Pediatr 87:638-642, 1975;.
21 +
McNeil JL, Ptasnik JA: Evaluation of long-term effects of elevated blood lead concentrations in asymptomatic children. Read before the International Symposium on Recent Advances in the Assessment of the Health Effects of Environmental Pollution, Paris, June 26, 1974.
22 +
Shoshone Lead Health Project , work summary. Boise, Idaho, Idaho Dept of Health and Welfare, 1976;, p 146.
23 +
Sartain P, Whitaker JA, Martin J:  Absence of lead lines in bones of children with early lead poisoning . Am J Roentgenol 91:597-601, 1964;.
24 +
Lin-Fu JS:  Vulnerability of children to lead exposure and toxicity . N Engl J Med 289:1229-1233, 1973;.
25 +
Wiener G:  Varying psychological sequelae of lead ingestion in children . Public Health Rep 85:19-24, 1970;.
26 +
Sachs HK, Krall V, McCaughran DA, et al:  IQ following treatment of lead poisoning: A patient-sibling comparison . J Pediatr 93:428-431, 1978;.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Byers RK, Lord EE:  Late effects of lead poisoning on mental development . Am J Dis Child 66:471-494, 1943;.
2 +
Perlstein MA, Attala R:  Neurologic sequelae of plumbism in children . Clin Pediatr 5:292-298, 1966;.
3 +
Rudolph AM: Pediatrics , ed 16, Barnett HL, Einhorn AH (eds). New York, Appleton-Century-Crofts Inc, 1977;.
4 +
Sachs HK: Ambulatory treatment of lead poisoning. Read before the Midwest and the Eastern Regional Conferences on Lead Poisoning, American Academy of Pediatrics, Chicago, May 10, 1972, and Wilmington, Del, June 2, 1972.
5 +
Sachs HK, Blanksma LA, Murray EF, et al:  Ambulatory treatment of lead poisoning: Report of 1,155 cases . Pediatrics 46:389-396, 1970;.
6 +
Steinfeld JL:  Medical aspects of childhood lead poisoning . Pediatrics 48:464-468, 1971;.
7 +
Wagman IH, Lesse H:  Maximum conduction velocities of motor fibers of ulnar nerve in human subjects of various ages and sizes . JNeurophysiol 15:235-244, 1952;.
8 +
Johnson EW, Olson KH:  Clinical value of motor nerve conduction velocity determination . JAMA 172:2030-2035, 1960;.
9 +
Mavor J, Libman I:  Motor conduction measurement as a diagnostic tool . Neurology 12:733-744, 1962;.
10 +
Lehmann EL: Nonparametrics: Statistical Methods Based on Ranks . San Francisco, Holden-Day Inc, 1975;.
11 +
Baer RD, Johnson EW:  Motor nerve conduction velocities in normal children . Arch Phys Med 46:698-704, 1965;.
12 +
Gamstorp I:  Normal conduction velocity of ulnar, median and peroneal nerves in infancy, childhood and adolescence . Acta Paediatr Scand , (suppl 146) , 1963;, pp 68-76.
13 +
Chisolm JJ:  The use of chelating agents in the treatment of acute and chronic lead intoxication in childhood . J Pediatr 73:1-38, 1968;.
14 +
Smith HD, Baehner RL, Carney T, et al:  The sequelae of pica with and without lead poisoning: A comparison of the sequelae five or more years later: 1. Clinical and laboratory observations . Am J Dis Child 105:609-616, 1963;.
15 +
Kaufman AS:  Comparison of the performance of matched groups of black children and white children on the Wechsler preschool and primary scale of intelligence . J Consult Clin Psychol 41:186-191, 1973;.
16 +
Shuey AM: The Testing of Negro Intelligence , ed 2. New York, Social Science Press, 1966;.
17 +
Results of the 1969-1970 City-Wide Testing Program . Chicago, Chicago Public Schools, Chicago Board of Education, 1971;.
18 +
Report on the City-Wide Testing Program in Reading Comprehension, 1974-1975 . Chicago, Chicago Public Schools, Department of Research and Evaluation, 1975;.
19 +
Havighurst RJ: The Public Schools of Chicago . Chicago, Board of Education, City of Chicago, 1964;.
20 +
De la Burde B, Choate MS:  Early asymptomatic lead exposure and development at school age . J Pediatr 87:638-642, 1975;.
21 +
McNeil JL, Ptasnik JA: Evaluation of long-term effects of elevated blood lead concentrations in asymptomatic children. Read before the International Symposium on Recent Advances in the Assessment of the Health Effects of Environmental Pollution, Paris, June 26, 1974.
22 +
Shoshone Lead Health Project , work summary. Boise, Idaho, Idaho Dept of Health and Welfare, 1976;, p 146.
23 +
Sartain P, Whitaker JA, Martin J:  Absence of lead lines in bones of children with early lead poisoning . Am J Roentgenol 91:597-601, 1964;.
24 +
Lin-Fu JS:  Vulnerability of children to lead exposure and toxicity . N Engl J Med 289:1229-1233, 1973;.
25 +
Wiener G:  Varying psychological sequelae of lead ingestion in children . Public Health Rep 85:19-24, 1970;.
26 +
Sachs HK, Krall V, McCaughran DA, et al:  IQ following treatment of lead poisoning: A patient-sibling comparison . J Pediatr 93:428-431, 1978;.

Correspondence

Submit a Letter
CME
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Clear Answers | Save For Later
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2013 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems