Basophilic Stippling Of Erythrocytes Research Articles

Anaemia and abdominal pain due to occupational lead poisoning

We describe a 47-year-old patient with chronic anaemia with basophilic stippling of erythrocytes, recurrent abdominal colics, discoloration of gums, sensitive polyneuropathy to the four limbs, hyperuricaemia, hepatosteatosis with raised transaminases, and a long ignored history of lead exposure in a battery recycling plant. The diagnosis of poisoning was confirmed by high lead levels in the blood and urine, decreased erythrocyte delta-aminolevulinic acid dehydratase (ALA-D), raised erythrocyte zinc protoporphyrin (ZP), and elevated urinary excretion of porphyrins. Chelation with EDTA resulted in increased urinary lead excretion, gradual improvement of the clinical picture, and progressive normalization of lead biomarkers. The case highlights the importance of occupational anamnesis for the diagnosis of lead poisoning, an uncommon condition which may mimic a variety of internal and surgical diseases. Since antiquity, lead has been extensively mined, produced, and utilized in a variety of industrial settings, such as metallurgy, construction, production of plastics, ceramics, paints and pigments. Lead and its compounds are systemic toxicants, and a wide range of adverse health effects (including haematological, gastrointestinal, neuropsychiatric, cardiovascular, renal, endocrine, and reproductive disorders) has been observed in exposed workers. The general population (particularly children) may also be exposed to toxic lead levels due to air, soil, food and water contamination. Thanks to the improvement of workplace hygienic conditions, the pathological picture of occupational lead poisoning (plumbism, saturnism) has gradually become less serious, at least in the most industrialized countries, and has progressively changed into aspecific, subclinical manifestations. We describe here an unusual case (nowadays) of anaemia and recurrent abdominal pain due to lead poisoning from battery recycling.

Getting the Lead Out

A 32-year-old man reported having had back and abdominal pain, nausea, and constipation for several weeks. The results of laboratory studies were notable for normocytic anemia, a hemoglobin level of 7.9 g per deciliter, a mean corpuscular volume of 82 μm3, and basophilic stippling of erythrocytes. The serum lead level was elevated, at 143.5 μg per deciliter (6.9 μmol per liter; normal, less than 10.0 μg per deciliter [0.5 μmol per liter]). The man had sustained a gunshot wound to the right elbow six years earlier. The radiograph of the elbow showed the presence of multiple radiodense opacities. The . . .

Anemia secundaria a intoxicación por plomo. Nuestra experiencia a propósito de 12 casos

A decrease in hemoglobin production is probably the main cause of anemia observed in patients poisoned by lead although hemolysis caused by the effects on membrane or by inhibition of other enzymes such as 5'-pyrimidine nucleotidase may also play a key role. The main lead exposure source comes from lead use in industry; however, outside occupational exposure, food and water consumption is the main cause of lead exposure. Clinical and analytical characteristics are reported of twelve patients with lead poisoning of food and water source occurred in the last 14 years in two health areas in north Extremadura. The exposure source was wine, vinegar and olives in one case, hand-made brandy in five, water consumption in houses with lead piping, and in two cases the cause was not determined. The clinical picture was similar in all cases with the exception of one female patient who had encephalopathy and hepatic failure. Diagnosis was suggested by regenerative anemia with basophilic stippling of erythrocytes. All patients received oral calcium disodium EDTA. Lead poisoning in non-industrial areas is a rare entity. Nevertheless, owing to the use of artisanal procedures for wine elaboration and derivatives, its occurrence is increasing. In a patient with symptoms of lead poisoning and regenerative anemia, a peripheral blood smear should be reviewed.

Toxicity of lead acetate to female rabbits after chronic subcutaneous administration. 1. Biochemical and clinical effects

The effect of chronic subcutaneous administration of lead acetate was studied in female rabbits. The low-dose group (15 animals) received three times a week 0.10-0.20 microgram/kg body weight and the high-dose group (15 animals) 0.80-1.20 micrograms/kg. The control group received the vehicle only. Concentrations of lead in blood in the low-dose group increased to ca. 400 micrograms/l after 70 days and in the high-dose group to ca. 900 micrograms/l after 110 days. After 7.5 months eight animals of each group were sacrificed. The remaining rabbits were kept for an additional 4 months without treatment. Blood lead concentrations decreased with a half-time of 60-70 days. During exposure the gain in body weight was lower in the high-dose group than in the control group and the low-dose group. The high-dose group developed slight anaemia and low MCV, MCH and MCHC, and basophilic stippling of erythrocytes. These effects disappeared during recovery. ALAD activity in erythrocytes was very low during exposure in both exposed groups and did not reach control values during recovery. During exposure the concentrations of ZPP and ALA-U increased, but only ALA-U returned to normal during recovery. No other effects of lead on the composition of the urine were observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of sample preparation on basophilic stippling in bovine blood smears.

The effect of sample preparation on the amount of basophilic stippling of erythrocytes (BSE) was studied using blood from a calf with chronic experimental lead poisoning. The combination of EDTA anticoagulation and rapid drying of the blood smear resulted in the most BSE. Alcohol prefixation reduced BSE. Wright-Leishman stain was better than Wright stain in demonstrating BSE.

Effects of inorganic lead on delta-aminolevulinic acid dehydratase activity and hematological variables in the rainbow trout, Salmo gairdnerii.

The activity of the enzyme delta-aminolevulinic acid dehydratase (ALA-D) was strongly depressed in erythrocytes, spleen and renal tissue of rainbow trouts (Salmo gairdnerii) exposed to sublethal levels of inorganic lead (10, 75 and 300 microgram Pb2+/L) for 30 days. The fish exposed to the highest lead concentration also showed an anemic response and basophilic stippling of erythrocytes. The lead exposure did not cause any alteration of the white blood cell picture. The ALA-D inhibition, the anemia and basophilic stippling seemed to persist in the lead-exposed fish even after a recovery period of seven weeks in lead-free water.

Evaluation of tests for the diagnosis of lead exposure in sheep.

Several laboratory tests that are currently used for the diagnosis of lead poisoning in man were evaluated for the detection of lead poisoning in sheep given 3 or 10 mg Pb/kg body weight/day for 7 weeks. Urinary porphyrins and basophilic stippling of erythrocytes were not sensitive indicators of lead poisoning in sheep, while urinary lead and urinary delta-aminolevulinic acid concentrations were too variable to have diagnostic value. However, erythrocyte delta-aminolevulinic acid dehydratase was strongly inhibited by exposure to relatively low doses of lead, while blood lead concentrations gave an indication of the level of exposure to lead poisoning.