180. Confusion, Anemia, and Abdominal Pain in a Toddler

  1. Christopher P. Holstege MD1,2,3,
  2. Alexander B. Baer MD1,4,
  3. Jesse M. Pines MD, MBA, MSCE5,6 and
  4. William J. Brady MD7,8,9

Published Online: 3 AUG 2011

DOI: 10.1002/9781444397994.ch180

Visual Diagnosis in Emergency and Critical Care Medicine, Second Edition

Visual Diagnosis in Emergency and Critical Care Medicine, Second Edition

How to Cite

Holstege, C. P., Baer, A. B., Pines, J. M. and Brady, W. J. (eds) (2011) Confusion, Anemia, and Abdominal Pain in a Toddler, in Visual Diagnosis in Emergency and Critical Care Medicine, Second Edition, Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444397994.ch180

Editor Information

  1. 1

    Division of Medical Toxicology, University of Virginia School of Medicine, Charlottesville, VA, USA

  2. 2

    Blue Ridge Poison Center, University of Virginia School of Medicine, Charlottesville, VA, USA

  3. 3

    Departments of Emergency Medicine & Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, USA

  4. 4

    Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA

  5. 5

    Center for Health Care Quality, George Washington University, Washington, DC, USA

  6. 6

    Departments of Emergency Medicine and Health Policy, George Washington University, Washington, DC, USA

  7. 7

    Department of Emergency Medicine, University of Virginia, Charlottesville, VA, USA

  8. 8

    Center for Emergency Management, University of Virginia Health System, Charlottesville, VA, USA

  9. 9

    Charlottesville-Albemarle Rescue Squad & Albemarle County, Fire Rescue, Charlottesville, VA, USA

Publication History

  1. Published Online: 3 AUG 2011
  2. Published Print: 12 AUG 2011

ISBN Information

Print ISBN: 9781444333473

Online ISBN: 9781444397994

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Keywords:

  • Case 70, confusion, anemia - and abdominal pain in toddler;
  • diagnosis - lead encephalopathy, due to ingestion of paint chips;
  • discussion, multiple radio-opacities in plain film, consistent with ingestion of paint chips;
  • list of more common radio-opacities - summarized by mnemonic CHIPES, calcium/chloral hydrate, heavy metals;
  • children, having a fairly efficient - absorption of lead, averaging 40–50%;
  • acute neurotoxicity, at higher levels - to cerebral edema, fluid egress across blood–brain barrier;
  • vomiting, anorexia, constipation and “lead colic” - in children;
  • lead encephalopathy, treated emergently - with chelation therapy;
  • dimercaprol, chelator of choice - readily crossing blood–brain barrier;
  • CaNa2EDTA, only other parenteral chelator - not crossing the blood–brain barrier

Summary

This chapter contains sections titled:

  • Further reading