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Lead Poisoning Related Anemia
Etiology:
- Ingestion of beverages rich in lead Ex: Alcohol distilled in lead flasks
- Consumption of flaking lead paint on articles by children
- Inhalation of lead containing fumes in industries
- Consumption of lead containing medications
Pathogenesis:
- Inhibition of membrane adenosine triphosphatase which leads to membrane damage and hemolytic anemia
- Generation of free radicals by Fenton reaction
- Inhibition of HMP shunt, leading to decreased RBC production
Classification:
- Chronic/ slow (Saturnism)- Neurological and nephrological symptoms
- Acute- CNS symptoms, hepatitis, nephrotoxicity, hypertension, abdominal colic, seizures, hemolytic anemia
Clinical Features:
- Anemia
- Tremors
- Abdominal pain
- Lead lines on gums
Investigations:
- Peripheral smear
- Normocytic/ microcytic hypochromic anemia
- Basophilic stippling-
- Disappears if blood is collected in EDTA
- These are abnormally aggregated ribosomes
- Bone marrow aspiration
- Ringed sideroblasts are seen
Treatment:
- PO. Meso 2,3 dimercaptosuccinic acid
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