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November 21, 1977

Lead, Health Food, and Leukemia-Reply

JAMA. 1977;238(21):2262-2263. doi:10.1001/jama.1977.03280220030005

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In Reply.—  In the patient's reminiscence, Dr Schwarz came off as the hero who had finally solved the problem of a long, miserable illness. His own recollection is colored otherwise. He states that he made a diagnosis of lead poisoning over the telephone based on "a rather inaccurate semiquantitative screening technique." He notes that the patient did not submit to a diagnostic test with EDTA; however, she had been advised that the drug might produce severe toxic reaction. Later during a febrile illness, a well known toxicologist observed that "she excreted 0.25 mg of lead in her urine in 24 hours. The excretion of this much lead is almost always associated with symptoms of lead poisoning. This opinion was further supported by the finding of stippled erythrocytes." These findings, the demonstration of lead contamination of the health food, and the patient's syndrome would seem to make the diagnosis of lead