Lead encephalopathy in infants in Kuwait. A study of 20 infants with particular reference to clinical presentation and source of lead poisoning.

Twenty patients aged between one and eighteen months (mean six months) were found to have lead encephalopathy. They were seen in one 30-bed ward during a four year period from 1977 to 1980. Blood lead was determined in 19 children and ranged between 2.9 and 12.4 mumol/l (60 and 257 micrograms/dl) mean 5.42 mumol/l (113 micrograms/dl). Two patients died before starting treatment. Of the 18 patients treated with B.A.L. (2.3 dimercaptopropanol) and EDTA (ethylenediaminetetra-acetic acid), three died. Eleven patients made an apparently complete recovery and four had neurological sequelae. The source of lead was traced in 18 patients: in 11 it was due to the liberal use of Kohl (also known as surma) commonly used as an eye cosmetic in the Arabian peninsula. Other local sources of lead poisoning are discussed.