Children's Hospital of New Jersey at Newark Beth Israel Medical Center, 201 Lyons Ave, Newark, NJ, 07112, US.
Rutgers New Jersey Medical School, Newark, NJ, US.
BMC Pediatr. 2024 Oct 29;24(1):687. doi: 10.1186/s12887-024-04871-3.
Lead encephalopathy, while thankfully rare, is a devastating and potentially fatal consequence of lead intoxication. Owing to successful public health measures, severe lead toxicity is not often encountered by most practicing physicians in the United States, making both its recognition and management challenging. A case study of a 4-year-old female presenting in refractory status epilepticus, found to have severe microcytic anemia and lead level > 100 mcg/dL.
We report a case of a 4-year-old girl who presented with refractory seizures, severe microcytic anemia, and a history of developmental delay who was ultimately diagnosed with lead encephalopathy, requiring multiple courses of calcium disodium ethylenediaminetetraacetic acid (EDTA) and succimer for rebounding lead levels.
Rapid recognition and appropriate management is essential to ensure neurologically intact survival. This case documents one of the first cases of successful lead chelation after multiple courses of calcium disodium EDTA and succimer dual therapy since the removal of dimercaprol from the United States market. This case also highlights the importance of using body surface area dosing for chelation therapy in order to prevent under-dosing in young children.
尽管铅性脑病较为罕见，但它仍是铅中毒的一种毁灭性且可能致命的后果。由于公共卫生措施的成功实施，美国大多数执业医师很少遇到严重的铅毒性，这使得其识别和管理都极具挑战。本文报告了一例 4 岁女性因难治性癫痫持续状态就诊的病例，其表现为严重小细胞性贫血和血铅水平>100μg/dL。
我们报告了一例 4 岁女孩的病例，其表现为难治性癫痫发作、严重小细胞性贫血和发育迟缓病史，最终被诊断为铅性脑病，需要多次使用钙二钠乙二胺四乙酸（EDTA）和二巯丁二酸来降低血铅水平。
快速识别和适当的管理对于确保神经功能完整的生存至关重要。该病例是在 dimercaprol 从美国市场撤出后，首次成功使用钙二钠 EDTA 和二巯丁二酸双重疗法多次治疗后进行成功螯合治疗的病例之一。该病例还强调了在儿童中使用体表面积剂量进行螯合治疗以防止剂量不足的重要性。
