Basophilic stippling with elevated ALA and FEP is most characteristic of exposure to which metal?

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Multiple Choice

Basophilic stippling with elevated ALA and FEP is most characteristic of exposure to which metal?

Lead exposure disrupts heme synthesis by inhibiting two key enzymes, ALA dehydratase and ferrochelatase. When these enzymes are blocked, ALA accumulates and so does free erythrocyte protoporphyrin (FEP) because iron can’t be properly incorporated into protoporphyrin IX to form heme. At the same time, lead impairs the degradation of ribosomal RNA in developing red cells, producing basophilic stippling. The combination of basophilic stippling with elevated ALA and FEP is a classic signal of lead poisoning, setting it apart from exposures to arsenic, mercury, or iron, which show different lab patterns and clinical features.

Lead exposure disrupts heme synthesis by inhibiting two key enzymes, ALA dehydratase and ferrochelatase. When these enzymes are blocked, ALA accumulates and so does free erythrocyte protoporphyrin (FEP) because iron can’t be properly incorporated into protoporphyrin IX to form heme. At the same time, lead impairs the degradation of ribosomal RNA in developing red cells, producing basophilic stippling. The combination of basophilic stippling with elevated ALA and FEP is a classic signal of lead poisoning, setting it apart from exposures to arsenic, mercury, or iron, which show different lab patterns and clinical features.

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