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Lead Poisoning in Children With Developmental Disabilities

STEPHEN B. SULKES, MD; DENNIS W. O'CONNOR, MD
Am J Dis Child. 1991;145(6):602. doi:10.1001/archpedi.1991.02160060018009.
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Sir.—We were pleased to read the article by Friedman and Weinberger1 in the September 1990 issue of AJDC regarding the screening, diagnosis, and treatment of children with lead poisoning. We describe a child with mental retardation whose pica behavior led to lead poisoning.

Patient Description.—An 8-year-old boy with previously diagnosed infantile autism and mental retardation underwent interdisciplinary team evaluation. The medical history incorporated questions regarding stereotypic behaviors, specifically pica. With confirmation of pica, a lead level of 3.13 μmol/L and an erythrocyte protoporphyrin level of 364 μg/dL were measured. Lead-based paint was discovered in the home of the boy's grandparents. He received chelation treatment with intramuscular calcium disodium ethylenediaminetetraacetic acid (EDTA) and oral penicillamine on an outpatient basis. His lead level dropped to 1.45 μmol/L. Repeated developmental testing 4 years later showed performance at the 8-month level in language skills and at the 2- to 3-year level

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