The Sequelae of Pica With and Without Lead Poisoning

Abstract

In spite of intense medical and sociologic effort, the incidence of lead poisoning remains high among children in many areas of the United States and the case fatality rate of lead encephalopathy continues to be approximately 25%. Of the survivors of pediatric plumbism, many have been reported to have significant residuals. Because the symptoms and signs of childhood lead intoxication may be vague or may mimic other common disorders, the diagnosis can be fraught with difficulty. During the past ten years in Cincinnati, a period in which 273 cases of excessive lead absorption have been documented among children, it has been observed repeatedly that a child initially may be labeled as having lead poisoning on the basis of a history of pica together with other signs and symptoms of possible lead intoxication, only to have analytic studies of the lead content of the objects chewed and of the child's blood