In a child presenting with symptoms of lead poisoning, what are the most effective diagnostic tests and treatment strategies to reduce blood lead levels and prevent long-term complications, and what further investigations and follow-up care are necessary to ensure optimal outcomes?
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diagnostic tests:
- blood lead levels
- CBC with peripheral smear
- LFT and RFT
treatment strategies
- remove lead source
- chelation therapy
- supportive care
Laboratory tests for lead poisoning:
- Complete blood count and peripheral smear. (Hypochromia and basophilic stippling are strongly suggestive of lead poisoning)
- Blood lead levels (BL) by spectroscopic methods.
- Urine analysis to identify ALA(aminolaevulinic acid) concentration, which serves as a sensitive indicator of lead poisoning.
- X-ray fluorescence technique
- It has been suggested that all children must be screened for the blood lead levels & an therapeutic indication is indicated for conc of >20mcg/100ml.
Calcium disodium EDTA mobilization test is also done mainly in children.
TREATEMENT:
- Eliminating poison sources from the body
- Chelation therapy
- Ventilatory support
- Fluid therapy