(C) (5'- nucleotides deficiency) (880-H 18(tm))Lead intoxication is accompanied by an acquired deficiency of erythrocyte pryimidine-specific, 5'-nucleotidase.Genetically determined deficiency of this enzyme is associated with chronic hemolysis, marked basophilic stippling of erythrocytes on stained blood films, and unique intraerythrocytic accumulations of pyrimidine-containing nucleotides.Basophilic stippling aka Punctatebasophilia refers to an observation found when observing a blood smear in which erythrocytes display small dots at the periphery. These dots are the visualization of ribosomes and can often be found in the peripheral blood smear, even in some normal individuals.Pyrimidine 5'- nucleotides (P 5 N) deficiency- P5N is a key enzyme in the catabolism of nucleotides arising from the degradation of nucleic acids that takes place in the final stages of erythroid cell maturation. How exactly its deficiency causes Hemolytic anemia is not well understood; but a highly distinctive features of this condition is a morphologicabnormality of the red cells known as basophilic stipplingHemolytic anemia caused by lead poisoning is characterized by basophilic stippling. It is infact a phenocopy of that seen in P5N deficiency, suggesting it is mediated at least in part by lead inhibiting then enzymeCauses of Basophilic Stippling in blood smear1. Thalassemias2. Hemoglobin s S - disease3. Hemoglobin s C disease4. Hemoglobin s E disease5. Iron deficiency6. Unstable hemoglobin s / Myelodysplasia7. Lead poisoning* Basophilic leucocytoses is seen in CML *