A patient with anemia is found to have a peripheral blood smear showing basophilic stippling. What is the most likely diagnosis?

A Lead poisoning ✓
B Iron deficiency anemia
C Thalassemia major
D Sideroblastic anemia

Explanation

Basophilic stippling is a characteristic finding in lead poisoning, where it represents aggregated ribosomal RNA. Lead inhibits several enzymes involved in heme synthesis, leading to the accumulation of denatured proteins and ribosomal RNA.

Source

Wintrobe's Clinical Hematology
Hematology Hematology: Anemia Hematology: Anemia Medium MEDICAL Confidence: high