Published online October 1, 2004
PEDIATRICS Vol. 114 No. 4 October 2004, pp. 1096-1099 (doi:10.1542/peds.2004-0361)
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EXPERIENCE AND REASON

Lead Poisoning From a Toy Necklace

Jessica L. VanArsdale, MD, MPH*, Richard D. Leiker, MS{ddagger}, Mel Kohn, MD, MPH§, T. Allen Merritt, MD, MHA||,¶ and B. Zane Horowitz, MD#

* Departments of Family Medicine and Public Health and Preventive Medicine
# Oregon Poison Center, Oregon Health and Science University, Portland, Oregon
{ddagger} Oregon Childhood Lead Poisoning Prevention Program
§ Disease Prevention and Epidemiology, Oregon Department of Human Services, Oregon Health Services, Portland, Oregon
|| St Charles Medical Center and Central Oregon Pediatric Associates, Bend, Oregon
Oregon Commission for Children and Families, Portland, Oregon

A 4-year-old, previously healthy boy experienced intermittent abdominal pain for several weeks. He was diagnosed with probable gastroenteritis, but his symptoms worsened. Laboratory tests revealed normocytic anemia, and an abdominal radiograph showed a metallic foreign body in the stomach, without evidence of obstruction. Endoscopy resulted in the retrieval of a quarter and a medallion pendant from the stomach. A venous blood lead level measurement was extremely elevated, at 123 µg/dL (level of concern: ≥10 µg/dL). The medallion was tested by the state environmental quality laboratory and was found to contain 38.8% lead (388 000 mg/kg), 3.6% antimony, and 0.5% tin. Similar medallions purchased from toy vending machines were analyzed and were found to contain similarly high levels of lead. State health officials notified the US Consumer Product Safety Commission, which resulted in a national voluntary recall of >1.4 million metal toy necklaces.

Key Words: lead • lead poisoning • lead foreign bodies

Abbreviations: LFB, lead foreign body • BLL, blood lead level • EDTA, calcium disodium versenate • ZPP, zinc protoporphyrin • RBC, red blood cell

Accepted Jun 14, 2004.


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eLetters:

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cause vs association
josephq scheller
Pediatrics Online, 14 Oct 2004 [Full text]
Re: cause vs association
Jessica L. VanArsdale
Pediatrics Online, 10 Nov 2004 [Full text]