Background:Patients, who survived from shotgun injuries, often have some retained lead pellets in their bodies. Several cases of lead toxicity have been reported regarding these patients.Objectives:This study seeks to compare the serum lead level in patients who have retained lead pellets in their bodies with the control group.Patients and Methods:In this case-control study, we gathered the serum lead levels of 25 patients with some retained lead pellets in their bodies due to shotgun and 25 volunteers without similar lead exposure and compared them in view of the age, gender, and living place.Results:While the mean serum lead level in both groups was lower than the standard level (i.e. 40 µg/dL) , the mean ± SD of serum lead level were 29 ± 12.8 µg/dL and 25.3 ± 6.4 µg/dL in the case and control groups, respectively without any significant difference (P = 0. 30) . However, a positive relationship was seen between serum lead level, and the number of retained lead pellets (r = 0.447, P = 0. 025) .Conclusions:Although extensive surgery to remove the lead pellets is not recommended in patients injured with shotguns, those with many retained lead pellets in their bodies should be considered at risk for lead poisoning and monitored carefully.

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Introduction: Methotrexate is one of the most effective agents in chemotherapy regimens for childhood ALL. However, methotrexate has remarkable side effects, which causes complications in various tissues and organs of some patients under treatment of this drug. It is proved that genetic factors can determine methotrexate toxicity. The aim of this study is to evaluate the effect of RFC-I A80G polymorphism on toxicity and serum level of methotrexate in children affected by acute lymphoblastic leukemia. Methods: A80G polymorphism of RFC-I was genotyped with PCR-RFLP method in 69 ALL patients treated with methotrexate. The relation between RFC-I genotypes and serum level of methotrexate and toxicity were evaluated using HPLC method and common terminology criteria for adverse events (CTCAE) respectively. Results: In this study, frequency of allele A for A80G polymorphism was 42.8% in patients who were studied. In consolidation phase, allele A frequency in patients with hepatotoxicity was higher than patients with no hepatic event (P=0.03, OR=2.32, 95% CI=1.10-4.98). Nevertheless, there were not any association between the other types of toxicity and RFC-I genotypes. Also, there was no association between A80G genotypes and the serum level of methotrexate. Conclusion: Based on the obtained results, we concluded that allele A of A80G polymorphism of RFC-I gene is a risk factor for methotrexate hepatotoxicity in consolidation phase and the A80G polymorphism can be utilized for prediction of methotrexate toxicity and dose adjustment.

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