Mnemonic: ABCDEFGH
Anemia:
- 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
Colic:
- Spasmodic pain involving smooth muscles of small and large intestine, ureter, uterus and blood vessels
- Temporarily relieved by atropine
Drop:
- 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
Enecephalopathy:
- 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:
- Calcium lactate or gluconate, Calcium citrate, Calcium disodium ethylenediamine tetraacetate
- Dimercaprol
- Penicillamine
- Iodides (to remove lead in bones)