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Lead poisoning
Other Resources UpToDate PubMed

Lead poisoning

Contributors: Abigail Clarkson-During MD, Benjamin L. Mazer MD, MBA, Michael W. Winter MD
Other Resources UpToDate PubMed


Lead poisoning is a heavy metal poisoning that occurs as a result of inhalation, ingestion, or skin absorption and accumulation of lead in the body. Lead poisoning requires a chronic exposure to high levels of lead and is not caused by an isolated exposure. It can be serious and sometimes lethal.

Lead is more harmful to children as they are able to absorb lead at a faster rate than adults. Their growth may be stunted and development impaired. Childhood lead poisoning can lead to serious health complications such as learning and hearing impairments, intellectual disability, growth retardation, and behavioral issues; convulsions, coma, and death may occur with higher levels of exposure.

In children, lead paint, dust, and contaminated soil are common exposures. Risk factors include living in a home with lead-based paint or with plumbing containing lead pipes or solder. Acute poisoning in children has also been associated with ingesting or chewing on a metal object such as metal jewelry.

Adults who work in industries such as battery manufacturing and recycling, construction work, auto repair, and lead smelting are at risk for occupational lead exposure. Other risk factors include certain hobbies (eg, making stained glass, refinishing old furniture, making ammunition) and living in a developing country.

Clinical presentations are variable and dependent on patient age and severity of poisoning, but they generally include peripheral neuropathy, encephalopathy, anorexia, albuminuria, anemia, headache, hypertension, insomnia, irritability, tremor, weight loss, and gastrointestinal symptoms.

Patients can be exposed to lead via contaminated air, water, dust, soil, and commercial products. Ayurvedic medicines may contain lead, arsenic, and mercury and can cause lead poisoning and other heavy metal poisonings. Opium can be contaminated with lead. Patients with chronic lead poisoning generally will not present with symptoms until there are high levels of lead in the blood system, making early diagnosis challenging and delays in diagnosis common. A blood test will help identify lead poisoning. Treatment includes removal from the source of exposure and consists of chelation therapy in chronic lead poisoning and bowel irrigation and gastric lavage in acute lead poisoning (ingested form).

Related topic: Lead nephropathy


T56.0X1A – Toxic effect of lead and its compounds, accidental (unintentional), initial encounter

1145155005 – Lead and lead compound poisoning

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Iron deficiency anemia
  • Porphyria – abdominal pain, anemia
  • Vitamin B12 deficiency – neuropathy
  • Folate deficiency – neuropathy
  • Carbon monoxide poisoning – altered mental status
  • Heavy metal toxicity (see, eg, Arsenic poisoning, Mercury poisoning, Thallium poisoning)
  • Deposition disease – Sarcoidosis, AL amyloidosis, Wilson disease, Hemochromatosis
  • Encephalitis, often infectious – tick-borne, viral, bacterial, or fungal

Best Tests

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Management Pearls

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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Last Reviewed:02/04/2019
Last Updated:01/06/2022
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Lead poisoning
A medical illustration showing key findings of Lead poisoning (Low Exposure) : Fatigue, Irritability, Lead exposure, Myalgia, Paresthesias
Clinical image of Lead poisoning - imageId=1931332. Click to open in gallery.  caption: '"Lead lines," characterized by a deep blue-gray discoloration at the gingival margins.'
"Lead lines," characterized by a deep blue-gray discoloration at the gingival margins.
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