Lead Poisoning - pediagenosis
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Saturday, May 29, 2021

Lead Poisoning

Lead Poisoning
Haemoglobin synthesis in the developing red cell
Figure 2.7  Haemoglobin synthesis in the developing red cell. The mitochondria are the main sites of protoporphyrin synthesis, iron (Fe) is supplied from circulating transferrin; globin chains are synthesized on ribosomes. δ‐ALA, δ‐aminolaevulinic acid; CoA, coenzyme A.

       Lead inhibits both haem and globin synthesis at a number of points. In addition it interferes with the breakdown of RNA by inhibiting the enzyme pyrimidine 5′ nucleotidase, causing accumulation of denatured RNA in red cells, the RNA giving an appearance called basophilic stippling on the ordinary (Romanowsky) stain (see Fig. 2.17). 
The anaemia may be hypochromic or predominantly haemolytic, and the bone marrow may show ring sideroblasts. Free erythrocyte protoporphyrin is raised.

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