Connect
MJA
MJA

Succimer therapy for congenital lead poisoning from maternal petrol sniffing

Suzanna T Powell, Srinivas Bolisetty and Gavin R Wheaton
Med J Aust 2006; 184 (2): 84-85.

An infant, born at 35 weeks’ gestation to a woman who sniffed petrol, had a cord blood lead level eight times the accepted limit. Treatment with oral dimercaptosuccinic acid promptly reduced his blood lead levels. To our knowledge, this is the first reported case of congenital lead poisoning secondary to maternal petrol sniffing. We suggest that at-risk pregnancies should be identified, cord blood lead levels tested, and chelation therapy and developmental follow-up offered to affected infants.

A 27-year-old Indigenous woman, who had sniffed petrol since childhood, presented for antenatal care during her first pregnancy. At the age of 14 years, she had severe lead encephalopathy that led to chronic neurological deficits, including permanent ataxia and memory impairment. Her serum lead levels at 8 and 35 weeks’ gestation were raised at 1.48 and 2.21 μmol/L, respectively (recommended level, ≤ 0.48 μmol/L1).

Please login with your free MJA account to view this article in full

  • Suzanna T Powell1
  • Srinivas Bolisetty2
  • Gavin R Wheaton3

  • 1 Tamworth Base Hospital, Tamworth, NSW.
  • 2 Royal Hospital for Women, Sydney, NSW.
  • 3 Women’s and Children’s Hospital, Adelaide, SA.

Correspondence: 

  • 1. National Health and Medical Research Council. Revision of the Australian guidelines for lead in blood and lead in ambient air Canberra: NHMRC, 1993.
  • 2. Frankenburg WK, Dodds J, Archer P, et al. The DENVER II technical manual. Denver, Colo: Denver Developmental Materials Inc, 1996.
  • 3. Treatment guidelines for lead exposure in children. American Academy of Pediatrics Committee on Drugs. Pediatrics 1995; 96 (1 Pt 1):155-160.
  • 4. Dietrich KN, Ware JH, Salganik M, et al. Effect of chelation therapy on the neuropsychological and behavioral development of lead-exposed children after school entry. Pediatrics 2004; 114: 19-26.
  • 5. Pocock SJ, Smith M, Baghurst P. Environmental lead and children’s intelligence: a systematic review of the epidemiological evidence. BMJ 1994; 309: 1189-1197.
  • 6. Canfield RL, Henderson CR, Cory-Slechta DA, et al. Intellectual impairment in children with blood lead concentrations below 10 microg per deciliter. N Engl J Med 2003; 348: 1517-1526.
  • 7. Tong S, Baghurst PA, Sawyer MG, et al. Declining blood lead levels and changes in cognitive function during childhood. The Port Pirie Cohort Study. JAMA 1998; 280: 1915-1919.
  • 8. Gardella C. Lead exposure in pregnancy: a review of the literature and argument for routine prenatal screening. Obstet Gynecol Surv 2001; 56: 231-238.
  • 9. Shannon M. Severe lead poisoning in pregnancy. Ambul Pediatr 2003; 3: 37-39.
  • 10. Tait PA, Vora A, James S, et al. Severe congenital lead poisoning in a preterm infant due to a herbal remedy. Med J Aust 2002; 177: 193-195. <MJA full text>
  • 11. Goodheart RS, Dunne JW. Petrol sniffer’s encephalopathy. Med J Aust 1994; 160: 178-181.
  • 12. Goodheart RS, Dunne JW. Petrol sniffer’s encephalopathy. Med J Aust 1994; 160: 178-181.
  • 13. Fortenberry, JD. Gasoline sniffing. Am J Med 1985; 79: 740-744.
  • 14. Dodd J. Petrol sniffing in a pregnant Aboriginal population: a review of maternal and neonatal outcomes. Aust N Z J Obstet Gynaecol 2001; 41: 420-423.
  • 15. Graziano JH, Lolacono NJ, Moulton T, et al. Controlled study of meso-2,3-dimercaptosuccinic acid for the management of childhood lead intoxication. J Pediatr 1992; 120: 133-139.
  • 16. Product information. Chemet (succimer). Deerfield, Ill: Ovation Pharmaceuticals Inc, 2003.
  • 17. Gulson BL, Mizon KJ, Korsch MJ, et al. Mobilization of lead from human bone tissue during pregnancy and lactation — a summary of long-term research. Sci Total Environ 2003; 303: 79-104.

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.