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Puberty and resultant increased bone turnover as a possible etiology of an increased lead concentration in a pre-adolescent girl. | LitMetric

AI Article Synopsis

  • - A 12-year-old girl experienced elevated blood lead levels (BLL) of 30 µg/dL, likely linked to changes during puberty, after previously being treated for high lead levels when she was younger.
  • - Her growth spurt, measuring over 10 cm in 15 months, coincided with the increase in lead concentration, and thyroid studies showed normal results.
  • - Monitoring osteocalcin levels and growth velocity may help doctors understand how puberty affects BLL in adolescents, especially when no external sources of lead exposure are identified.

Article Abstract

We present a case in which puberty likely resulted in an increased lead concentration in a pre-adolescent girl. A 12-year-old girl was referred to the pediatric environmental health clinic (PEHC) after her blood lead level (BLL) was found to be elevated to 30 µg/dL (reference <5 µg/dL). She had been seen in the PEHC 6 years previously for management of a BLL as high as 36 µg/dL. Fifteen months prior to her repeat PEHC referral, her BLL had been 10 µg/dL. In those intervening 15 months, she grew 10.42 cm. Thyroid studies were normal. Four months after re-referral, her osteocalcin concentration, a marker of bone turnover, was 212 ng/mL (normal 9-42 ng/mL in adults >18 years); 10.5 months after the peak BLL of 32 mcg/dL, her BLL was 16 µg/dL, osteocalcin was 69 ng/mL, and her rate of growth had declined to 0.20 cm/30 days (peak: 1.07 cm/30 days). No external source of her exposure was found. Osteocalcin concentrations and plotting the changes in growth velocity over time may assist clinicians in determining if pubertal growth is playing a role in unexpectedly increased BLL discovered in adolescents for whom no external source of lead exposure can be found.

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Source
http://dx.doi.org/10.1080/15563650.2019.1688340DOI Listing

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