A girl licks paint that is peeled of from the toys, develop acute abdominal pain, tingling sensation of hands and legs and weakness. Which enzyme is inhibited in this child?
## **Core Concept**
The symptoms described - acute abdominal pain, tingling sensation in hands and legs, and weakness - following the ingestion of peeled paint from toys, are suggestive of lead poisoning. Lead poisoning inhibits several enzymes in the body, disrupting heme synthesis.
## **Why the Correct Answer is Right**
The correct answer involves the inhibition of **δ-aminolevulinic acid dehydratase (ALAD)**, also known as porphobilinogen synthase. This enzyme is crucial in the biosynthesis of heme, which is a vital component of hemoglobin, myoglobin, and various other hemoproteins. Lead inhibits ALAD, which leads to the accumulation of δ-aminolevulinic acid (ALA) and results in the clinical manifestations of lead poisoning, including abdominal pain, neuropathy (tingling sensation and weakness), and others.
## **Why Each Wrong Option is Incorrect**
- **Option A:** This option is incorrect because while ** ferrochelatase** is indeed another enzyme involved in heme synthesis and is inhibited by lead, it is not the primary enzyme associated with the acute symptoms described. Ferrochelatase inhibition leads to a decrease in heme production and an accumulation of protoporphyrin IX.
- **Option B:** This option refers to another enzyme in the heme biosynthetic pathway but is not directly related to the primary effect of lead poisoning described.
- **Option D:** This option might refer to an unrelated or less directly related enzyme to the symptoms described.
## **Clinical Pearl / High-Yield Fact**
A key clinical pearl is that lead poisoning classically causes a **painter's colic** (severe abdominal pain), peripheral neuropathy (weakness and tingling in hands and legs), and can also cause developmental delays and cognitive impairments in children. The inhibition of **δ-aminolevulinic acid dehydratase (ALAD)** by lead is a critical biochemical mechanism underlying these clinical manifestations.
## **Correct Answer:** .