Basophilic stippling in red blood cells in the bone marrow: indication for lead poisoning diagnosis. Issue 2 (February 2022)

• Record Type: Journal Article
• Authors: Kano, Nagamasa; Fukui, Sayato; Kushiro, Seiko; Inui, Akihiro; Saita, Mizue; Kura, Yoshimasa; Sawada, Umihiko; Naito, Toshio
• Is Part Of: Journal of international medical research. Volume 50:Issue 2(2022)
• Publication Date: 2022-02
• Subjects: Lead poisoning -- anaemia -- blood smear -- basophilic stippling -- bone marrow biopsy -- transformed red blood cell; Medicine -- Periodicals; Pharmacology -- Periodicals; 610.5
• DOI: 10.1177/03000605221078405
• Languages: English
• ISSNs: 0300-0605

Abstract

A 40-year-old man presented at our hospital with anaemia that had been undiagnosed for 2 years. Blood tests, endoscopy, and contrast-enhanced computed tomography were performed, but a definitive diagnosis could not be made. A subsequent bone marrow biopsy revealed basophilic stippling in transformed red blood cells, which led to a differential diagnosis of lead poisoning. Additional tests revealed elevated levels of lead in the blood. Basophilic stippling is generally found on a peripheral blood smear in lead poisoning patients; however, in this case, basophilic stippling was found only on the bone marrow smear and not in the blood smear. Even if basophilic stippling is not found in the peripheral blood, lead poisoning cannot be excluded.