Which type of anemia is indicated by basophilic stippling and often associated with heavy metal exposure?

Basophilic stippling in red blood cells is characteristic of lead poisoning. This stippling occurs due to the accumulation of ribosomal RNA within the red blood cells, which is caused by the disruption of heme synthesis as a result of lead's interference with several key enzymes in the heme production pathway, particularly delta-aminolevulinic acid dehydratase and ferrochelatase.

Lead exposure can arise from various sources such as old paint, contaminated water, or industrial exposure. In children, lead poisoning is particularly concerning because it can lead to severe neurological damage in addition to hematological changes, including basophilic stippling and microcytic anemia. The presence of lead leads to ineffective erythropoiesis and the manifestation of symptoms associated with anemia like fatigue and pallor.

Iron deficiency anemia, sideroblastic anemia, and anemia of chronic disease have different underlying pathophysiologies and do not typically present with basophilic stippling. Iron deficiency anemia is characterized by microcytic hypochromic red blood cells and a lack of iron stores. Sideroblastic anemia involves the presence of ringed sideroblasts in the bone marrow due to failure in incorporating iron into heme. Anemia of chronic disease results