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University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository

Specialty

Primary Care

Advisor

Elijah Salzer, DMSc, PA-C, NYSAFE, C-EFM

Abstract

A three-year-old male with chronic iron deficiency anemia was seen in the primary care clinic and found to have a venous blood lead level of 73μg/dL. Diagnostic testing revealed retained lead paint chips in the intestines. He underwent two treatments with oral succimer chelation. The local public health department performed an evaluation and found peeling lead paint chips on a window sill, which was mitigated with paint stabilization and eventual window replacement. Venous blood lead levels eventually dropped to 35 μg/dL. Lead toxicity remains prevalent with children under six years of age more commonly affected and susceptible. Routine screening at ages one and two or between 36-72 months of age if not previously screened is recommended. Targeted lead screening is aimed at the most high-risk groups, including children from low-income families and children living in houses built before 1978. Recent research has also shown that children with elevated blood lead levels are more likely to have iron deficiency anemia. Healthcare providers should be aware of the Centers for Disease Control's (CDC) recent blood lead reference level change from 5 to 3.5 μg/dL.

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