Lead

Abstract 

Lead poisoning is one of the oldest diseases known to man, and exposures still occur occupationally and following ingestion of lead-containing materials. Lead may be absorbed following inhalation or ingestion and is stored primarily in bone; elimination is predominantly renal. There are two principal mechanisms of lead toxicity. First, lead complexes with important functional chemical groups and, secondly, lead substitutes for divalent ions with the potential for widespread chemical interactions. Among the most important enzymes disrupted by lead are several of those involved in haem synthesis. This results in anaemia; haemolysis and basophilic stippling also occur. Manifestations of lead poisoning may arise in most organ systems and range from sub-clinical abnormalities to acute clinical emergencies. Management involves exposure avoidance and, in more severe cases, chelation therapy with either sodium calcium edetate or DMSA.

Keywords: δ-aminolaevulinic acid, chelation, DMSA, encephalopathy, ferrochelatase, lead poisoning, neuropathy, sodium calcium edetate, traditional remedies, zinc protoporphyrin