Aly M H, Kim H C, Renner S W, Boyarsky A, Kosmin M, Paglia D E
Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick 08903.
Am J Hematol. 1993 Dec;44(4):280-3. doi: 10.1002/ajh.2830440412.
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.
在一名留有猎枪子弹碎片的患者中观察到有症状的铅中毒伴严重溶血性贫血。手术切除留存的子弹碎片并使用一种新型螯合剂二巯基丁二酸成功降低了血铅水平。溶血性贫血与红细胞嘧啶5'-核苷酸酶缺乏有关，铅水平的降低纠正了这种缺乏，这表明酶缺乏是铅中毒相关溶血的原因。该病例说明猎枪伤留存的铅弹可导致严重铅中毒。
