HEMOLYTIC-ANEMIA ASSOCIATED WITH LEAD-POISONING FROM SHOTGUN PELLETS AND THE RESPONSE TO SUCCIMER TREATMENT

Symptomatic lead poisoning with severe hemolytic anemia was observed i n 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. Hemol ytic anemia was associated with deficient erythrocyte pyrimidine 5'-nu cleotidase, and lowering of the lead level corrected the deficiency, s uggesting that the enzyme deficiency is responsible for the hemolysis associated with lead poisoning. This case illustrates that retained le ad pellets from shotgun wounds can cause severe lead poisoning. (C) 19 93 Wiley-Liss, Inc.