# Acute Haemolytic Anaemia Secondary to Lead Poisoning: A Case Report

## TL;DR

A 30-year-old man developed lead poisoning from Indian Ayurvedic medicine, causing anemia and requiring chelation therapy.

## Contribution

Highlights lead toxicity as a rare but important cause of hemolytic anemia, especially in users of traditional medicines.

## Key findings

- Elevated lead levels (73.3 µg/dL) were found in a patient with hemolytic anemia and basophilic stippling.
- Ingestion of Indian Ayurvedic medicine was identified as the likely source of lead exposure.
- Chelation therapy led to clinical improvement, emphasizing the need for early diagnosis and treatment.

## Abstract

Lead toxicity (plumbumism) is a rare but clinically significant diagnosis in developed countries. It can manifest with a wide array of systemic and haematological symptoms. Due to its non-specific presentation and overlap with common conditions such as iron deficiency anaemia, diagnosis may be delayed without a high index of suspicion. We report a case of a 30-year-old previously healthy male patient who presented with generalised abdominal pain, jaundice, constipation, and lethargy. Laboratory investigations revealed a microcytic, hypochromic anaemia with indirect hyperbilirubinaemia and Coombs-negative haemolysis. Peripheral smear demonstrated basophilic stippling, prompting a lead level assessment, which returned markedly elevated (73.3 µg/dL). Upon further history, the patient disclosed recent ingestion of Indian Ayurvedic medicine, which was identified as the likely source of lead exposure. Chelation therapy was initiated with clinical improvement. This case highlights the importance of considering lead toxicity in the differential diagnosis of haemolytic anaemia, especially in patients using complementary or imported medicines. Peripheral smear findings, particularly basophilic stippling, can provide a vital clue. Early recognition and chelation therapy are essential to prevent long-term complications. Clinicians should maintain caution for lead poisoning in atypical anaemia presentations and take thorough exposure histories, including the use of traditional medicines.