American Medical Association Family Medical Guide - American Medical Association [200]
Diagnosis
To diagnose iron deficiency anemia, a doctor will take blood samples to measure the level of iron. To rule out other causes, such as internal bleeding or a problem in the digestive tract that blocks iron absorption, a doctor may recommend tests such as a stool analysis to check for blood (which could indicate internal bleeding), or X-rays of the digestive tract.
WARNING!
Iron Supplements
Accidental overdose of iron through supplements is the leading cause of poisoning death in children under age 6. If your doctor has prescribed iron supplements for your child, administer them exactly as directed. To prevent an overdose or poisoning, always keep all supplements out of the reach of children.
Treatment
To treat mild iron deficiency anemia, the doctor will make dietary recommendations to help the child get sufficient iron from his or her diet, such as ensuring that the child has an adequate intake of vitamin C, which facilitates iron absorption. To treat severe iron deficiency anemia caused by lack of iron in the diet, the doctor may prescribe iron supplements (usually in liquid form) for your child to take for 2 months or longer. If the anemia results from an underlying disorder, the doctor will recommend appropriate treatment.
Lead Poisoning
Lead is an extremely toxic metal that is easily absorbed by the body. If swallowed or inhaled, lead is absorbed in the intestines or the lungs, enters the bloodstream, and travels to soft tissues such as the liver, kidneys, or brain, where it is stored. Lead also can be stored in the bones and teeth.
Lead poisoning is the No. 1 environmental disease among children in the United States, affecting about one of every five children. Children under age 6 have an increased risk of lead poisoning because their body is able to absorb very high amounts of lead. Lead usually enters a child’s body when he or she eats paint chips (from lead-based paints that were available before 1978) or contaminated soil. A child can also be exposed to lead when he or she inhales polluted air outdoors or paint dust in the air at home, or from sucking or chewing on surfaces coated with lead-based paint such as furniture, windowsills, railings, or the slats of window blinds.
Common environmental sources of lead include lead-based paint, soil, tap water, and lead dust brought home from the workplace on clothing. Other, less common sources of lead include lead crystal containers, lead-soldered cans, and lead-glazed pottery.
Symptoms
Although mild lead poisoning often does not cause symptoms, some children may experience irritability, headache, muscle aches, drowsiness, fatigue, poor appetite, constipation, abdominal pain, vomiting, or weight loss. Poor nutrition may lead to anemia (see previous page). Severe lead poisoning may lead to hyperactivity, behavior problems, hearing problems, delayed growth, learning disabilities (see page 415), mental retardation, seizures, or brain damage. The effects of long-term exposure to lead can be severe and usually are irreversible.
Diagnosis
A diagnosis of lead poisoning is based on a child’s symptoms and the results of a physical examination. The doctor will order a blood test to measure the amount of lead in the child’s blood. A blood level of 10 micrograms or more of lead per 1 deciliter of blood (mcg/dL) indicates lead poisoning. In severe cases, a doctor may order X-rays of the abdomen and the bones in the arms and legs to look for deposits of lead.
Treatment
The main treatment for lead poisoning is to eliminate lead from the child’s environment or to remove the child from the contaminated environment. For mild lead poisoning, a doctor may prescribe a drug called a chelating agent, which will bind with the lead and help the body eliminate it in urine. The drug may be taken orally or may be injected into a muscle. To help prevent or reduce absorption of lead, the doctor may recommend a diet that is high in iron and calcium and low in fat. Children with severe lead poisoning (a blood level higher than 20 mcg/dL)