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The Possibility of Occult Lead Poisoning–Reply–II *

We thank Dr Brown for drawing attention to an unusual cause of anemia that can affect elderly persons. Although the magnitude of risk from hair dyes is uncertain,1-3 environmental exposure to lead is common enough that lead intoxication should routinely be considered in the differential diagnosis of unexplained anemia, especially in patients from outside the United States.4 In addition to the paint and toys mentioned by Dr Brown, nonoccupational sources of lead exposure have included ceramic glazes5 (a potential danger for nursing home residents participating in ceramic arts programs6), traditional medicines,7 cosmetics (especially kohl-based eyeliner8), candy,9 metal lunchboxes,10 and several others. Although the peripheral blood smear often reveals basophilic stippling in lead intoxication, this test is neither specific nor highly sensitive, and other assays such as blood lead and erythrocyte zinc protoporphyrin measurements might be necessary to make the diagnosis.

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As with any procedure, there could be pain or other substantial risks involved. These concerns should be discussed with your health care provider prior to any treatment so that you have proper informed consent and understand that there are no guarantees to healing.

THE INFORMATION IN THIS WEBSITE IS OFFERED FOR GENERAL EDUCATIONAL PURPOSES ONLY AND DOES NOT IMPLY OR GIVE MEDICAL ADVICE. No Doctor/Patient relationship shall be deemed to have arisen simply by reading the information contained on these pages, and you should consult with your personal physician/care giver regarding your medical treatment before undergoing any sort of treatment or therapy.

Published on 05-04-2009