Anemia associated with lead
Anemia associated with lead
Updated: 07/24/2024
© Jun Wang, MD, PhD
General features
- Children <6 years especially vulnerable
- May severely affect mental and physical development
Pathogenesis
- Inhibits enzymes involved in heme synthesis
o Ferrochelatase
§ Incorporation of iron into protoporphyrin
§ Elevated free erythrocyte chelates with zinc
- δ-aminolevulinate dehydratase
- Coproporphyrin oxidase
Clinical features
- In children
o Developmental delay, learning difficulties, irritability, loss of appetite, weight loss, sluggishness and fatigue, abdominal pain, vomiting, constipation, hearing loss, seizures, pica (eating things that aren't food, like paint chips or dirt)
o
Bluish discoloration along gum (lead line), rare, suggestive of severe and prolonged lead exposure
o Prenatal expose associated with premature birth and lower birth weight
- In adults
o High blood pressure
o Difficulties with memory or concentration
o Mood disorders
o Headache, abdominal pain, joint and muscle pain
o Reduced sperm count and abnormal sperm
o Miscarriage/stillbirth or premature birth
Laboratory findings
- Ring sideroblasts: iron deposit forming a ring around the nucleus by iron stain
- Microcytic hypochromic anemia with basophilic stippling
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