December 29, 2020
biochemistry of lead poisoning
This exposition was pandemic in the Roman Empire, and it has been claimed that it contributed to its fall, but it also caused numerous epidemics in Western countries until the nineteenth century. Lead poisoning is the potential impairment caused by lead ingestion, and it affects almost every organ in the body. Probably the best known of these were the lead aqueduct and water-pipe systems that were found throughout the Roman Empire. The prognosis for lead poisoning improved markedly with the introduction of two antidotes, British Anti-Lewisite (BAL) and calcium disodium edatate (CaNa2-EDTA). The primary hematologic effect of lead is interference at multiple points along the heme synthetic pathway. Characteristic signs of lead poisoning are related to CNS derangement. According to the Agency for Toxic Substance and Disease Registry, a small amount of ingested lead (1%) will store itself in bones, and the rest will be excreted by an adult through urine and feces within a few weeks of exposure. 2019 Jan;187(1):230-242. doi: 10.1007/s12011-018-1375-1. Of course, lead was also an ingredient of coins, and of the glazes used in ceramics, a practice that still occurs in many places today. Such episodes made it apparent that lead encephalopathy was the predominant form of lead poisoning in infants and children. Thanks Dr. Mills! Childhood lead poisoning places an enormous burden on affected children, their families and society as a whole. The case presented with gastrointestinal complaints and history of intake of herbal medicines for diabetes control for past 8 months. Hence, lead toxicity has been noticed in elderly retired workers from battery manufacturing plants. The spectrum of neurologic toxicity varies from inattentiveness, irritability, and hyperactivity to learning disabilities, delayed growth, hearing loss, motor paralysis, and encephalopathy (Mendelsohn et al., 1998). The signs and symptoms of lead toxicity may resemble those of sickle cell disease, including abdominal pain, peripheral neuropathy with extremity pain, constipation, and hyponatremia.399 Lead toxicity should be considered in the differential diagnosis of children with unusual manifestations of sickle cell disease. Lead poisoning, on the other hand, shows its heme-related effects mainly in blood cells and can cause a form of anemia (a condition where blood is unable to carry oxygen sufficiently – usually either because there are too few red blood cells and/or not enough functioning hemoglobin). Yip and associates403 found a 30% incidence of anemia in less severely affected children (CDC classes I to III), but of those with either mild or no iron deficiency, only 6% were anemic. In 2010, 6% of impoverished children aged 1 to 2 years were found to have lead levels above the upper reference range.394 Additionally, children arriving from other countries with less stringent public health requirements regarding lead exposure remain at risk for significant lead toxicity.395 Increasing evidence shows that even low levels of lead exposure are associated with a significant decline in neurodevelopmental outcome, and in 1991, the CDC lowered the intervention level of lead in the blood from 25 to 10 µg/dL.395,396 Reviews of the public health issues relating to lead poisoning in children have been published.397. Neuropathy, seen in lead poisoning, may also be the result of disorders of heme biosynthesis, as in the porphyrias.262 Alterations in porphyrin metabolism have provided a useful means of detecting and assessing the severity of lead exposure and poisoning. Lead is a highly toxic metal and a very strong poison. Arthur Kim Ritchey, ... Frank G. Keller, in Hematology (Seventh Edition), 2018, Lead poisoning in children has been a serious public health problem for decades. The author emphasizes the essential distinction between lead eiicephalopathy due to poisoning by inorganic lead, and the cerebral symptoms due to the tetra-ethyl lead contained in leaded benzine. It has been estimated that <5% of the total lead in blood is bound to plasma proteins and that only 0.01% of … In activity of erythrocyte ALA dehydratase and elevated erythrocyte protoporphyrin levels are the common. 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