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Hemolytic anemia associated with lead poisoning from shotgun pellets and the response to succimer treatment
Author(s) -
Aly Mahmoud H.,
Kim Hugh C.,
Renner Stephen W.,
Boyarsky Andrew,
Kosmin Martin,
Paglia Donald E.
Publication year - 1993
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830440412
Subject(s) - lead poisoning , medicine , shotgun , hemolytic anemia , anemia , chemistry , psychiatry , biochemistry , gene
Symptomatic lead poisoning with severe hemolytic anemia was observed in a patient with retained shot gun pellets. Surgical resection of the retained pellets and the use of a newer chelating agent, Succimer (2,3‐dimercaptosuccinic acid) successfully lowered blood lead level. Hemolytic anemia was associated with deficient erythrocyte pyrimidine 5′‐nucleotidase, and lowering of the lead level corrected the deficiency, suggesting that the enzyme deficiency is responsible for the hemolysis associated with lead poisoning. This case illustrates that retained lead pellets from shotgun wounds can cause severe lead poisoning. © 1993 Wiley‐Liss, Inc.