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My sister moved into a new house with her sons aged 3 and 5. We’re worried about lead poisoning in the kids. They’re due for their physical exams next week. The doctor can test for lead? If so, how much lead requires treatment?

Lead paint was commonly used in houses built before 1950s and automobiles prior to the 1980s. Exposure can lead to developmental delays, cognitive defects, anemia, and gastrointestinal disturbances. Lead is commonly tested for on routine pediatric visits with finger sticks being an easy screening tool and venous lead levels drawn for quantitative blood lead levels if exposure is suspected. The high end of normal is 9 mcg/dL. The following guidelines is recommended for pediatric patients exposed to lead:

1) Blood lead levels 9 – 44 mcg/dL
– requires an investigation of the child’s environment and removal of the lead source or removal of the child.

2) Blood lead levels 45 – 69 mcg/dL
– requires an investigation of the child’s environment and removal of the lead source or removal of the child.
– monotherapy with succimer, calcium edetate, D-penicillamin, or dimercaprol.

3) Blood lead levels 69 – 100 mcg/dL
– requires an investigation of the child’s environment and removal of the lead source or removal of the child.
– requires admission to hospital and inpatient care.

4) Blood lead levels > 100 mcg/dL
– requires an investigation of the child’s environment and removal of the lead source or removal of the child.
– requires admission to hospital and acute inpatient care as encephalitis is likely.

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