Basophilic stippling is seen which of the following cells
Correct Answer: RBC's
Description: LEAD Chronic Poisoning (plumbism; saturnism) Signs and Symptoms :- (1) Facial Pallor : The facial pallor paicularly about the mouth is one of the earliest and most consistent sign. It seems to be due to vasospasm. (2) Anaemia : There may be polycythaemia with polychromatophilia in early stages, but later there is anaemia which is associated with polychromasia, punctate basophilia, reticulocytosis, poikilocytosis, anisocytosis, nucleated red cells (sideroblasts) and an increase in mononuclear cells, whereas polymorphonuclear cells and platelets are decreased. The anaemia is probably due to decreased survival time of red blood cells and inhibition of haeme synthesis by interference with the incorporation of iron into protoporphyrin. Punctate basophilia or basophilic stippling means the presence of many dark blue-coloured pinhead- sized spots in the cytoplasm of red blood cells, due to toxic action of lead on porphyrin metabolism. Reticulocytes and basophilic stippled cells result from the inhibition of 5 pyrimidine nucleotidase, an impaired ability to rid the cell of RNA degradation products and the aggregation of ribosome. (3) Line : A stippled blue line, called Buonian line, is seen on the gums. It appears due to subepithelial deposit of granules at the junction with teeth, only near diy or carious teeth, within a week of exposure, especially on upper jaw. It is due to formation of lead sulphide by the action of hydrogen sulphide formed by decomposed food in the mouth. (4) Colic and Constipation : It is usually later symptom. Colic of intestines, ureters, uterus and blood vessels occur in 85% of cases. The colic occurs at night and the pain may be very severe. Constipation is usual but diarrhoea or vomiting may occur. (5) Lead Palsy: It usually occurs late, and is seen in less than 10% of cases. There may be tremors, numbness, hyperaesthesia, and cramps before the actual muscle weakness. It is commoner in adults than in children, and men are paicularly affected. The muscle groups affected are those most prone to fatigue. Usually the extensor muscles of the wrist (wrist drop; radial nerve is affected) are affected, but the deltoid, biceps, anterior tibial (foot drop), and rarely muscles of eye or intrinsic muscles of hand or foot are affected. The paralysis is associated with degeneration of the nerve and atrophy of the muscles. Recovery may be complete but is usually slow. ( 6) Encephalopathy : It is common in children often associated with tetraethyl lead. The symptoms are vomiting, headache, insomnia, visual disturbances, irritability, restlessness, delirium, hallucinations, convulsions, coma and death. Lead encephalopathy is usually irreversible and about 85% have permanent brain damage. Death occurs in about 25% cases. Ref:- k s narayan reddy; pg num:-544,545
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