International Journal of Preventive Medicine (Int J Prev Med)2008-78021032019031820087802ENDepartment of Toxicology and Pharmacology, Faculty of Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University (IAUPS), TehranDepartment of Forensic Toxicology, Legal Medicine Research Center, Legal Medicine Organization, TehranTehran University of Medical Sciences (TUMS), Tehran20190318<p><span class="fontstyle0"><strong>Background</strong>: </span><span class="fontstyle2">Lead may be added to the opium by drug smugglers. It can cause elevated blood lead level (BLL) in opium‑addicted patients. Erythrocyte pyrimidine 5′‑nucleotidase (P5N) activity is susceptible to high BLL. The aim of this study was to fnd out whether opium‑addicted patients<br />show erythropathy and elevated liver enzymes explainable by high BLL and decreased P5N activity. </span></p><p><strong></strong><span class="fontstyle0"><strong>Methods</strong>: </span><span class="fontstyle2">Forty orally opium‑addicted subjects and 40 normal healthy volunteers were enrolled in this study. BLL was measured in whole blood specimens using atomic absorption spectrometry instrumentation. Enzymatic activity, protein amount of P5N, and erythrocyte purine/pyrimidine ratio were determined. Blood flms were analyzed for the presence of basophilic stippling of red cells and hemolytic anemia. The level of liver function enzymes was measured. </span></p><p><span class="fontstyle0"><strong>Results</strong>: </span><span class="fontstyle2">The mean BLL for opium‑addicted patients was signifcantly higher than control group (</span><span class="fontstyle3">P </span><span class="fontstyle2">&lt; 0.001). On the contrary, P5N activity showed a valid decrease in opium‑addicted patients when compared with control group (</span><span class="fontstyle3">P </span><span class="fontstyle2">&lt; 0.001). In line with repressed P5N activity, erythrocyte purine/pyrimidine ratio in patients was lower than control group (</span><span class="fontstyle3">P </span><span class="fontstyle2">&lt; 0.001). A statistically signifcant reverse correlation was found between BLL and P5N activity (</span><span class="fontstyle3">P </span><span class="fontstyle2">&lt; 0.05, </span><span class="fontstyle3">r </span><span class="fontstyle2">= -0.85). The prevalence of both basophilic stippling (</span><span class="fontstyle3">P </span><span class="fontstyle2">&lt; 0.001, </span><span class="fontstyle3">z </span><span class="fontstyle2">= 6.62) and hemolytic anemia (</span><span class="fontstyle3">P </span><span class="fontstyle2">&lt; 0.001, </span><span class="fontstyle3">z </span><span class="fontstyle2">= 6.52) in study population was signifcantly associated with elevated BLL. We could not fnd any signifcant correlation between serum level of liver enzymes and BLL. </span></p><p><span class="fontstyle0"><strong>Conclusions</strong>: </span><span class="fontstyle2">Opium‑addicted patients in Tehran, Iran, are at<br />high risk of lead poisoning which may result in hematologic problems and possibly hepatic damage.<br /></span></p><p><span class="fontstyle0" style="color: #00652e;"><strong>Keywords</strong>: </span><span class="fontstyle3">Anemia, lead poisoning, liver function tests, opium, pyrimidine 5′‑nucleotidase</span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2024http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2024/717717844