Category: Hematology

Lead poisoning

Symptoms and signs:

  1. GI: abdominal pain, constipation, anorexia, lead lines on gum(Burton’s lines)
    Image result for lead lines gum lead poisoning
  2. Neurological : headache, neurocognitive deficits(forgetfullness, encephalopathy, behavior problems, language regression; childrens especially susceptible due to incomplete BBB maturation), motor/sensory peripheral neuropathies(stocking-glove pattern ddx with GBS, DM… etc, extensor weakness)
  3. Hematologic:al microcytic anemia(99% bound to erythrocytes and can disrupt heme synthesis)
  4. Nonspecific signs: fatigue, irritability, insomnia,
  5. Chronic s/s: hypertension, nephropathy

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Blood transfusion reactions

Anaphylactic: Rapid onset(seconds to minutes) of shock, respiratory distress(difficulty breathing with wheezing or bronchospasm), angioedema, urticaria and hypotension. Occurs in those that are IgA deficient, due to the production of anti-IgA IgG Abs.

Treatment: Stop transfusion, antihistamines, steroids and IM epi. +/- hemodynamic support with vasopressor and MV.

Prevention: Future transfusion with IgA-deficient plasma and washed red cell products.

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