Lead Poisoning

Lead Poisoning Clinical Presentations:


Just remember ABCDEFGH (I remember it as "A-GGHH! Lead poisoning!")

1. Anemia. Pb denatures enzymes (ferrochelatase, ALA dehydrase) leading to ringed sideroblasts (faulty heme synthesis, iron accumulates in mitochondria of RBC progenitors)
2. Basophilic stippling. Pb also degrades ribonuclease, which degrades ribosomes. Mature RBCs normally have no ribosomes.
3. Colic w/ Diarrhea. (lead deposits in GI tract. Can visualize with radiographic image)
4. Encephalopathy in children. δ-ALA accumulates, increasing vessel permeability (edema) and causing demyelination. Often presents as headaches and memory loss in adults
5. Foot drop. More specifically, peripheral neuropathy. Consequences: foot drop (perineal nerve palsy), wrist drop (radial nerve palsy), claw hand (ulnar nerve palsy)
6. Growth retardation and Gum deposition. Pb accumulates in epiphyses, causing growth retardation and increased densities on bone radiograph. Pb also lines your gums.
7. Pb causes Nephropathy. This can lead to impaired uric acid secretion (Gout/Hyperuricemia) and Hypertension