Chronic Lead Poisoning : Mnemonic

Mnemonic: ABCDEFGH

chronic lead poisoning


  • Results from ALA dehydrogenase inhibition
  • Also causes RBC membranes to be permeable to K+ and decrease Na+/K+ ATPase leading to hemolysis

Basophilic stippling

Burtonian lines:

  • Gum “lead lines” develop in 2-50%
  • Results from subepithelial deposit of lead sulfide granules on gingival margins


  • Spasmodic pain involving smooth muscles of small and large intestine, ureter, uterus and blood vessels
  • Temporarily relieved by atropine


  • Wrist/Foot drop following tremor, numbness, hyperesthesia, fibrillation or cramps
  • Results from degeneration of nerve and atrophy of muscles
  • Occurs in less than 10%

Dotted retina:

  • Retinal stippling about the optic disc, with gray lead particles


  • Frequently in young children
  • Ranges from change of personality, restlessness, dullness and fatigue to convulsion, delirium or coma

Facial pallor:

  • Earliest sign
  • May result from vasospasm

Growth retardation:

  • Due to accumulation of lead in epiphysis

Hyperuricemia and Hypertension:

  • Due to nephropathy

Treatment of chronic lead poisoning:

  1. Calcium lactate or gluconate, Calcium citrate, Calcium disodium ethylenediamine tetraacetate
  2. Dimercaprol
  3. Penicillamine
  4. Iodides (to remove lead in bones)

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