Conclusions

This case highlights that significant lead poisoning may occur in young children despite the complete absence of clinical symptoms. The combination of pica, iron-deficiency anaemia, and potential exposure to deteriorating household paint should prompt clinicians to have a low threshold for measuring blood lead levels, even in otherwise well children. Early identification allowed timely initiation of chelation therapy and environmental intervention before the development of overt lead toxicity, reducing the risk of long-term neurodevelopmental sequelae. This case reinforces the importance of recognising risk factors, addressing nutritional deficiencies, investigating environmental sources of lead exposure, and ensuring close multidisciplinary collaboration between paediatricians, toxicology services and public health teams to optimise patient outcomes.