The anaemia of lead poisoning

J.clin.Path (1961), 14, 548

The Anaemia of Lead Poisoning

H.E. HUTCHISON AND J.M. STARK

From the Department of Haematology, the University and Western Infirmary, Glasgow

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SYNOPSIS: Three cases of lead poisoning with a hypochromic anaemia, despite adequate iron stores, are presented and discussed.

The anaemia of lead poisoning is usually thought to be normochromic and normocytic, and punctate basophilia is regarded as a constant feature of the well-developed case

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Formerly the anaemia in lead poisoning was attributed to a shortened survival of cells in the circulation but more recently the importance of interference with haemoglobin synthesis has been recognized, and this is demonstrated in two of our three patients in whom an inability to use available iron despite active eyrthropoiesis was an important factor in the development of the anaemia. Only in the third did the haemolytic element predominate.

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DISCUSSION

More than one mechanism has been blamed for the production of the anaemia of lead poisoning. The red cells may be rendered more ‘brittle’ by the lead (Aub, Fairhill, Minot, and Reznikoff, 1925) and therefore may have a shorter life span than normal.

Received for publicatin 7 March 1961.