title: Hemolytic anemia associated with lead poisoning from shotgun pellets and the response to Succimer treatment.
abstract: Symptomatic lead poisoning with severe hemolytic anemia was observed in a patient with retained shot gun pellets. Surgical resection of the retained pellets and the use of a newer chelating agent, Succimer (2,3-dimercaptosuccinic acid) successfully lowered blood lead level. Hemolytic anemia was associated with deficient erythrocyte pyrimidine 5'-nucleotidase, and lowering of the lead level corrected the deficiency, suggesting that the enzyme deficiency is responsible for the hemolysis associated with lead poisoning. This case illustrates that retained lead pellets from shotgun wounds can cause severe lead poisoning.
authors.affiliation: Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick 08903.
authors.forename: M H
authors.initials: MH
authors.lastname: Aly
authors.forename: H C
authors.initials: HC
authors.lastname: Kim
authors.forename: S W
authors.initials: SW
authors.lastname: Renner
authors.forename: A
authors.initials: A
authors.lastname: Boyarsky
authors.forename: M
authors.initials: M
authors.lastname: Kosmin
authors.forename: D E
authors.initials: DE
authors.lastname: Paglia
mesh_terms: D000328:Adult; D000743:Anemia, Hemolytic / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007855:Lead Poisoning / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D011859:Radiography; D004113:Succimer / Q000627:therapeutic use*; D014948:Wounds, Gunshot / Q000150:complications* / Q000000981:diagnostic imaging
chemical_list: D004113:Succimer