||1. The finger stick is the initial test for Dx, if lead found to be eleveted then in the next 48 hrs you must f/u w/venous blood lead level.
2. Erythrocyte protoporphyrin level also might be eleveted and must be f/u to see the response to chelation.
3. Children on chelation Therapy can have rebound high lead levels at 4 to 6 weeks due to release of lead from bones. Threfor its important to do blood lead f/u in these chidren.
20-44=MONTHLY monitoring of lead levels until the levels decrease to 20.
then, EVERY 4 MONTHS until the levels are <10
45-70= constant monitoring and chelation Tx, Succimer=DMSA is the 1st line (hepatotoxicity &BM supression)(do regular LFT & CBC), Ca edetate, Bal/Dimercaprol, Penicillamine.
then, monitor ONCE A WEEK until levels <44.
>70= HOspital ADmition & monitoring while on parenteral Tx