Boy Develops Acute Brain Herniation from Lead Toxicity

Case study sheds light on symptoms, dangers of lead intoxication

WEDNESDAY, Dec. 6 (HealthDay News) -- Lead toxicity may cause acute brain herniation, according to the case-study of a 4-year-old boy, published in the December issue of Pediatrics.

Sheldon Berkowitz, M.D., and Rod Tarrago, M.D., of Children's Hospitals and Clinics of Minnesota in Minneapolis, report on a 4-year-old black boy who presented with vomiting, low-grade fever and dehydration. They thought the symptoms were caused by viral gastroenteritis, but the boy's condition worsened over the next 12 hours, resulting in acute brain herniation followed by brain death.

X-rays were ordered, but not taken due to the accelerated progression. Autopsy results found a heart-shaped charm in the patient's stomach that was 99 percent lead.

As a result of this case, "we believe that in patients with vomiting and neurologic changes, lead intoxication should be considered as a diagnosis even when brain imaging either shows no cerebral edema or shows signs of a mass lesion," the study authors write. "Providers should also consider lead toxicity in patients with unexplained symptoms such as vomiting, developmental delay, hearing loss, behavioral problems, seizures or anemia."

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