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Blood lead levels in children with Encephalopathy


To determine the prevalence of elevated blood lead levels (EBLL i.e blood lead >10 micrograms/dL, Centers Disease Control criteria) in children with encephalopathy. SETTING: Hospital. DESIGN: Case control study. PARTICIPANTS: 100 children, 49 with encephalopathy and 51 consecutive hospital controls. OUTCOME MEASURES: Blood lead levels, demographics, clinical, environmental correlates and residual neurological sequel or death at discharge. RESULTS: 42 (encephalopathy) and 49 (hospital controls) children were available for analysis. The overall (n=91) mean blood lead was 7.88+/-10.44 micrograms/dL (range 0.07-67.68 micrograms/dL). The predictors of EBLL were presence of wasting (P<0.03), anemia (P<0.04), use of surma (P< 0.02), recent removal of house paint (P<0.01) or recently repainted (P<0.01). The mean blood lead levels were significantly higher (P<0.01) in patients of encephalopathy (12.18+/- 13.90 micrograms/dL) than in controls (4.19+/- 2.84 micrograms/dL). EBLL was present in 3/17 (17.6%) patients with infective encephalopathy and in 18/25 (72%) with non-infective encephalopathy. The proportion of children with residual neurological sequelae, or death increased when associated with EBLL (0 to 21%, and 69% to 100% respectively). CONCLUSION: Children hospitalized with encephalopathy have elevated blood lead levels.
Indian Pediatr. 2009;46:845-8.

By: Patel A, Athawale A

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