Alcohol, most common.
Alcohol poison resulting
Another cause, lead.
Not only would lead inhibit
the enzyme called what?
D – dehydratase.
But then also in the other side,
meaning as you’re getting
near to producing your heme,
you’re also going to then
Knocking out those two enzymes.
How in the world are you
supposed to form heme?
And what about this child?
Oh, abdominal pain.
Maybe lead encephalopathy, not
doing well in school, low IQ,
the lead might then actually accumulate
in your epiphyseal growth plate.
And so therefore, there’s lack
of endochondral ossification.
That child is not going to grow very tall.
So they’ll be short-statured.
In addition, at some point
in time, later on in life,
there might be lead type of neuropathies.
And lastly, I told you about you
something like lead nephropathy.
Keep that in mind from head to toe.
And the other thing that we’ll take a
look at later is basophilic stippling.
And what that basically means is
there is going to be accumulation
of the ribosomes and
RNA particles and such
in your cells because of
poisoning of these enzymes.
Next, what if your patient was
taking INH without the B6?
May result in lack of
activity of what enzyme?
Do not forget that another
name for B6 is pyridoxine.
Also keep in mind, B6 deficiency,
ladies and gentlemen,
could also result in
And do not forget, I wish
to introduce this you
and when we talk about WBC pathology,
I’ll be going into myelodysplastic
syndrome in much greater detail
and talk to you about a subtype,
where it’s called refractory
anemia of ring sideroblasts.
Four major different causes of more or less,
acquired type of sideroblastic anemia.
If there’s a deficiency of that enzyme,
you then call that you X-linked
recessive ALA synthase deficiency.
Each of these inhibit different parts
of the mitochondria, heme synthesis,
that we talked about via different
mechanisms in that previous picture.