Patients with chronic lead poisoning usually appear very sick. Physical examination of patients with lead poisoning is usually remarkable for neurological^[1], gastrointestinal^[2], and hematological problems.^[3]

• Physical examination of patients with lead poisoning is usually remarkable for:

• Burton’s line

• Peripheral neuropathy

• Wrist drop

• Learning disability

• Patients with lead poisoning usually appear normal.

• Tachycardia with regular pulse might be present due to anemia

• Skin examination of patients with lead poisoning is usually normal.

• Abnormalities of the head may include: ^[3][4]
• Burton’s lines^[5]
• Icteric sclera
• Irritability
• excess lethargy
• hyperactivity
• seizure
• coma
• learning disability^[1]

• Neck examination of patients with lead poisoning is usually normal.

• Pulmonary examination of patients with lead poisoning is usually normal.

• Cardiovascular examination of patients with lead poisoning might experience chest pain.

Abdominal examination of patients with lead poisoning might reveal^[3]:

• vomiting
• poor appetite
• weight loss

• Back examination of patients with lead poisoning is usually normal.

• Genitourinary examination of patients with lead poisoning might show:
• Acute nephropathy – manifests with tubular defects, including phosphaturia, glucosuria and amino aciduria. This combination of tubular defects is referred as Fanconi’s syndrome.
• Chronic nephropathy – characterized histologically with chronic interstitial nephritis and is associated with gout and hypertension.

• Neuromuscular examination of patients with lead poisoning might manifest with the following:^{[4] [6]}
• Patient is usually oriented to persons, place, and time
• Delirium
• Hallucinations
• Weakness of extensor muscles (eg, foot drop, wrist drop)
• Hypersomnolent or have difficulty falling asleep
• ataxia
• aggressiveness
• attention difficulty

• Foot drop
• Wrist drop
• Peripheral neuropathy

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