Plumbism is caused by -
lead-Mechanism of Action* Combines with sulphhydryl enzymes and inhibit cell metabolism* It also inhibits following enzymes required for heme synthesis and causes anemia1. Aminolaevulinic acid dehydratase2. Aminolaevulinic acid synthetase3. Coproporphyrinogen oxidase4. Ferrchelatase* It causes hemolysis Chronic Poisoning* Called as plumbisim, saturnism* Myalgia* Paraesthesia* Fatigue* Irritability* Abdominal discomfo/pain* Ahralgia* Tremor* Headache* Anorexia* Vomiting* Weight loss* Facial pallor - especially around the mouth (circum-oral pallor) is considered as consistent sign of chronic lead poisoning. It is due to vasospasm in addition to anemia * Anemia - is due to impairment in heme synthesis and is hypochromic and microcytic type anemia. There is reduced erythrocyte life span* Blood - there are immature red cells in circulation such as reticulocytes and basophilic stippled cells. Basophilic stippling or punctate basophilia means presence of many dark coloured pinhead sized spots in the cytoplasm of red blood cells. The spots are aggregation of ribonucleic acid (RNA) due to inhibition of the enzyme pyrimidine-5' nucleotidase that normally eliminates degraded RNA.* Lead line (Buonian line) - a bluish line is present on gums. The line formation is due to lead sulphide. Lead sulphide is formed due to action of hydrogen sulphide gas, liberated from the decomposed food in the mouth, with lead.* Colic and constipation (dry belly ache) - Colic affects intestine, ureter or uterus. The attack of colic lasts for few minutes and is in form of severe, intermittent cramps.During colic, the abdominal wall is rigid and contracted. Constipation is associated with the colic.* Lead palsy - is a late phenomenon. The extensor muscles are paralyzed causing wrist drop or foot drop. It is motor type of paralysis. The motor paralysis is due to:1. Interference with phosphocreatine metabolism2. Peripheral neuropathy.* Lead encephalopathy - it is more common in children and presents with sudden onset of vomiting, irritability, headache, ataxia, veigo, convulsions and coma.* Hypeension* Aeriosclerotic nephritis* Amenorrhea* Sterility* Aboion. REF;THE SYNOPSIS OF FORENSIC MEDICINE:KS NARAYANA REDDY;28th EDITION;PAGE NO307
Lead poisoning
Mercury poisoning
Thallium poisoning
Copper poisoning
Poisoning