Vastly different presentations between children and adults
CNS symptoms predominate
Lethargy, fatigue, headache, irritability, memory loss, tremor
Severe symptoms: altered mental status, coma, seizures, cerebral edema
PNS<unk> 
Causes segmental demyelination
Peripheral neuropathy
Upper >> Lower extremities
Extensors >> Flexors
Causes segmental demyelination
Peripheral neuropathy
Upper >> Lower extremities
Extensors >> Flexors
Upper >> Lower extremities
Extensors >> Flexors
Highest body levels found in proximal tubules after acute exposure
Results in proteinuria, particularly β 2-microglobulin and N-acetylglucosidase.
associated with slightly decreased GFRs
Results in proteinuria, particularly β 2-microglobulin and N-acetylglucosidase.
Basophilic stippling
From precipitation of nuclear contents
Inhibitor of heme synthesis
Can<unk>  to either a normochromic or hypochromic anemia
From precipitation of nuclear contents
Can<unk>  to either a normochromic or hypochromic anemia
Can cross placenta
Because<unk>  is stored in bones and there is higher bone turnover during pregnancy, women with previous<unk>  can have<unk>  intoxicated children despite mother being asymptomatic.
Higher rate of stillbirths and spontaneous abortion
May cause preterm labor and low birth weights
May slow mental development and cause lower intelligence later in childhood
Decreased sperm counts
Because<unk>  is stored in bones and there is higher bone turnover during pregnancy, women with previous<unk>  can have<unk>  intoxicated children despite mother being asymptomatic.
changes in T4 and TSH (generally with PbB > 40-60ug/dl)
altered levels of testosterone, leutonizing hormone, FSH at PbB > 30-40ug/dl
May also have GI upset, vomiting, constipation, elevated LFTs
Myalgias
associated with increased mortality due to cardiovascular disease
associated with increased blood pressure
May see thin, blue/black line along gingiva, known as Burton's line (more common in chronic poisoning)
Encephalopathy appears at lower levels
Symptoms: Irritability, apathy, fatigue, obtundation
Severe symptoms: Cerebral edema, Seizures
Can<unk>  to permanent changes in brain architecture
Inhibits enzymes that mediate arborization of synapses and neuronal cellular adhesion molecules
Hippcampus thought to be primary sight of action secondary to high zinc levels
Disturbs blood brain barrier permeability which can be chronic
Long term sequelae
Cognitive disturbances (from slight learning disability to profound intellectual disability)
Loss of 5 IQ points per 10μg/dL elevation
Hyperactivity, aggression and antisocial behaviors
Peripheral neuropathy similar in adults and children
Inhibits enzymes that mediate arborization of synapses and neuronal cellular adhesion molecules
Hippcampus thought to be primary sight of action secondary to high zinc levels
Cognitive disturbances (from slight learning disability to profound intellectual disability)
Loss of 5 IQ points per 10μg/dL elevation
Hyperactivity, aggression and antisocial behaviors
Impaired vitamin D activation
Similar to adults
Disturbs bone development
Accelerates skeletal maturation which may predispose to osteoporosis later<unk>  lines on radiographs
Generally correlate with levels above 50μg/dL
Associated with development of dental caries and periodontal bone loss
Accelerates skeletal maturation which may predispose to osteoporosis later
Generally correlate with levels above 50μg/dL
Lead toxicity
Aluminum toxicity
Gold toxicity
Antimony toxicity
Mercury toxicity
Arsenic toxicity
Copper toxicity
Barium toxicity