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Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le samedi 15 février 2020
Doi : 10.1016/j.arcped.2020.01.005
Received : 27 January 2019 ;  accepted : 25 January 2020
Non accidental repeated lithium poisoning in a child: The role of hair analysis

C. Pouchoux a, A.L. Pelissier b, J.M. Gaulier c, d, K. Retornaz e, C. Di Meglio f, J.C. Dubus a, e, E. Bosdure a,
a Pediatrics unit, CHU de Timone enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France 
b Department of forensic medicine, CHU de Timone adultes, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France 
c Unité fonctionnelle de toxicologie, CHU de Lille, 59000 Lille, France 
d Université de Lille, EA 4483–IMPECS–IMPact de l’environnement chimique sur la santé humaine, 59000 Lille, France 
e Pediatrics unit, CHU du Nord, Chemin-des-Bourrely, 13915 Marseille cedex 20, France 
f Unit of pediatric neurology, CHU de Timone enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France 

Corresponding author.

Non accidental intoxication due to child abuse is rare and its frequency is likely underestimated because it is difficult to diagnose. Here, we report a case of voluntary repeated exposure to lithium in an infant, for whom the clinical manifestations were convulsions. Toxicological analysis was very helpful for documenting lithium exposure during the assumed period of time. Interpreting the results of hair analysis, a simple and minimally invasive examination, is tricky at this age, but it can facilitate the differentiation of acute versus chronic exposure. Although infrequent and underestimated, lithium should be considered as a cause of intoxication in a previously healthy child with acute seizure.

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Keywords : Non accidental intoxication, Toxicological analysis of hair, Lithium, Seizure, Infants, Child(ren), Repeated poisoning

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