THE DIAGNOSTIC IMPORTANCE OF GLYCOSURIA IN LEAD POISONING IN CHILDHOOD
| Arch Dis Chilh 34:70-3, 1959,
pp 70, 73 THE
DIAGNOSTIC IMPORTANCE OF GLYCOSURIA IN BY RONALD C. ROXBURGH and LEONARD HAAA From the Queen Elizabeth Hospital for Children and The London Hospital (Received for publication July 24, 1958) In 1926, McKhann described three cases of lead poisoning in small children; he noticed, among other symptoms and signs, that marked but transient glycosuria was present in two of the three cases. Seven years later McKhann and Vogt (1933) reviewed all the case notes of children with lead poisoning admitted to the Boston Infants and Children’s Hospitals between the years 1924 and 1933. These amounted to 89 cases, and the presence of glycosuria had been noted ‘frequently’ especially in the presence of encephalopathy. In a similar review from New York Goettsch and Mason (1940) collected records of 39 cases of lead poisoning between 1923 and 1938; in this series the incident of glycosuria was 20%. In one of the cases glycosuria persisted for five weeks. More recently Ennis and Harrison (1950) found glycosuria in four out of 10 cases of lead poisoning. Burrows, Rendle-Short and Hanna (1951) reported that glycosuria was commonly found in such cases. Six years ago, one of us (R.C.R.) in conjunction with Millichap and Llewellin (1952) reported five cases of lead poisoning in young children due to ingestion of paint. It was noticed at that time that two of the cases had had glycosuria for a short period at the onset, but the diagnosis in those cases had been established on other evidence. Further reports of childhood lead poisoning have come from Zak and Finkelstein (1952), Gianattasio, Bedo and Pirozzi (1952), Wilson, Thomson and Dent (1953), Byers, Maloof and Cushman (1954), Marsden and Wilson (1955) Tanis (1955), and O’Donohoe (1956). In many of these cases it had been noticed that glycosuria was present. However, it had apparently been an incidental finding and the purpose of this paper is to show the diagnostic value of glycosuria, especially in the cases of lead poisoning without encephalopathy. In the following three cases, seen consecutively, it was the presence of marked glycosuria in the absence of a raised blood sugar level that led to a search for other evidence of lead poisoning. * * * * [Any] child who is otherwise unwell, the diagnosis of lead poisoning must always be considered. The experience gained during the treatment of the cases with oral calcium di-sodium Versenate leads us to suggest that prolonged courses are without danger to the patient and, in addition, continue to enhance the renal excretion of lead in increased amounts. That the excretion of lead should be as complete as possible is shown by Henderson (1954) from Queensland, Australia, who gives evidence of the danger of chronic renal disease occurring in young adults who had been afflicted with lead poisoning in childhood. So far, no such series of cases has been reported in this country. SUMMARYThree further cases of lead poisoning in children are described. The diagnosis of the condition was reached at an early stage after admission to hospital because of the discovery of glycosuria, which led to further tests for lead poisoning. The glycosuria persisted for three weeks. There was no evidence of residual renal damage at the end of six months. All three cases were treated with prolonged courses of oral calcium di-sodium Versenate resulting in prolonged excretion of lead in the urine. Evidence is put forward to suggest that colored crayons of the yellow and orange ranges may be a danger to children on account of their content of lead chromate. We are grateful to Dr. Helen Mackay, to Dr. C.T. Porter, and to Dr. Richard Dobbs for permission to publish these cases which were under their care: to Dr. J.A. Bonnell for much assistance, advice and many urine-lead estimations carried out in the Department for Industrial Medical Research at the London Hospital; to Dr. B. Levin for numerous laboratory investigations at the Queen Elizabeth Hospital. Anderson, J.A. (1954). In Textbook of Pediatrics, 6th ed. Ed. W.E. Nelson, p. 630. Philadelphia. Best, C.H. and Taylor, N.D. (1955). The Physiological Basis of Medical Practice, 6th ed. London. Blackman, S.S. Jr. (1936). Bull. Johns Hopk. Hosp., 58, 384. Bonnell, J.A.L. (1957). Personal communication. Brown, R.J.K. and Gray, J.D. (1955). Canad. Med. Ass.J., 73, 192. Burrows, N.F.E., Rendle-Short, J. and Hanna, D. (1951). Brit. Med. Jr., 1, 329 Byers, R.K., Maloof, C.A. and Cushman, M. (1954) A.M.A. Amer.J.Dis.Child., 89, 159. Chisolm, J.J. and Harrison, H.E. (1956). Pediatrics, 18, 943. ______, Harrison, C., Eberlein, W.R. and Harrison, H.E. (1955). A.M.A. Amer.J. Dis. Child., 89, 159. Ennis, J.J. and Harrison, H.E. (1950). Pediatrics, 18, 943. Gianattasio, R.C., Bedo, a.V. and Pirozzi, M.J. (1952) A.M.A. Amer..J.Dis.Child., 84, 316. Goettsch, E.and Mason, H.H. (1954). A.M.A. Amer..J.Dis.Child., 59, 119. Henderson, D.A. (1954). Aust.Ann.Med., 3, 219. Marsden, H.B. and Wilson, V.K. (1955). Brit.med.J., 1, 324. McKhann, C.F. (1926). Amer.J.Dis. Child,, ,32, 386. ______ and Vogt, E.C. (1933). J. Amer. Med. Ass. 101, 1131. Millichap, J.G., Llewellin, K.R. and roxburgh, R.C. (1952), Lancet, 2, 360. O’Donohoe, N.V. (1956). Arch. Dis. Childh., 31, 321. Tanis, A.L. (1955). A.M.A. Amer.J. Dis. Child., 89, 325. Voegtlin, C. and Hodge, H.C. (1949). Pharmacology and Toxicology of Uranium Compounds. McGraw-Hill, New York. Wilson, V.K., Thomson, M.L. and Dent, C.E. (1953). Lancet, 2, 66. Zak, F.F. and Finkelstein, W.E. (1952). J. Mt. Sinai Hosp., 19, 352. |
|
I promise to answer your message -- click here to send me a personal message
|
SUBSCRIBE: The Wednesday Letter is a free electronic monthly newsletter written and published by Karl Loren. You can view more than 50 back issues of this publication by clicking here. The Wednesday Letter subscription list is maintained on a secure server, no name is ever given or sold to anyone, and it is never used except for this Newsletter. It is automatically published on the Tuesday night just before the first Wednesday of every month. You can subscribe to this free monthly electronic letter by entering your eMail address and name below. You will then automatically receive a request for confirmation, sent to whatever address you have entered. If you do NOT receive this confirmation request, then you will not be subscribed. There may have been an error with your address and you should resubmit. The letter is never sent twice to the same address -- so you do not have to worry about a duplicate subscription. When you receive this confirmation request you must reply to it, or your subscription will not become active. No one can subscribe your name, and address, without you being notified, and if you get an unwanted notice of subscription you only need to DO NOTHING and the subscription will NOT be active.
REMOVAL: You can remove yourself from the subscription list in several different ways. Click here to read about this entire newsletter system. Every edition of The Wednesday Letter is delivered to your address with YOUR name and address in view on the letter, with a link that allows you to remove THAT name from the subscription list. If you try to send this removal message from an address different from the one you used to send in your original confirmation, then you will get a warning notice first, sent to the subscription address, asking you to confirm that you want to be removed from the list -- by replying to THAT request for confirmation, you will then be automatically removed. Thus, no one else can unsubscribe you, from some other computer, without your knowledge. But, if you send in the unsubscribe notice from the same machine used to receive the Letter, then the removal from the subscription list is automatic.
Personal Message: When you send a personal message to Karl Loren, you will receive a personal reply as per his instructions. Karl pledges that every personal message will get a personal answer. When you provide your mail address, we will send you free information including our free catalog and a cassette tape lecture by Karl Loren about heart disease, no charge, by mail, even if outside the US. You can select particular information you would like to receive, along with the free cassette tape and catalog.
You can reach Vibrant Life in many ways, including by mail to Vibrant Life, 2808 N. Naomi St., Burbank, CA 91504. Within the US and Canada, use the toll free number: (800) 523-4521, the local number: (818) 558-1799, the FAX: (818) 558-7299, eMail to kimberly@oralchelation.com or any one of the hundreds of message forms throughout the 50 web sites. Vibrant Life normally ships the same day we get an order. There are message forms on each of the 100,000+ pages on this and other sites where you can communicate with Vibrant Life. Check out our companion site, at: http://www.oralchelation.net where Karl's 2000 page book is published. Karl Loren is the author and webmaster for this BOOK, as well as for another web site about ORAL CHELATION. His personal philosophical articles are at PHILOSOPHY.
Copyright © May 20, 2008 6:24 AM by Karl Loren on behalf of Vibrant Life, ALL RIGHTS RESERVED. Permission is granted for non-commercial downloading, copying, distribution or redistribution on two conditions: One, that some form of copyright notice is included in every copy distributed or copied, showing the copyright belonging to Vibrant Life, Burbank, CA, at www.oralchelation.com . The second condition is that the material is not to be used for any purpose contrary to the purposes and objectives of this site. This permission does not extend to materials on this site which are copyrighted by others.
