Conclusion
This case emphasizes that all patients with unknown disease should be evaluated in terms of PBS at the first work up and the PBS in all patients (hematologic and non- hematologic) should be reviewed systematically regarding all blood elements. Lead poisoning is more common than our estimation. As clinical manifestations are non-specific and may be misdiagnosed with other pathophysiological conditions, at least it should be included in differential diagnosis lists of adult unexplained anemia (especially in the setting of matched clinical data) and basic initiative laboratory tests such as PBS could rule out the need for invasive, expensive and time consuming procedures.

List of abbreviations

Mean cell volume: MCV, Mean cell hemoglobin: MCH, Mean cell hemoglobin concentration: MCHC, Red-cell–distribution width: RDW, Myelodysplastic syndrome: MDS, Complete blood count: CBC, Peripheral blood smear: PBS, Blood urea nitrogen: BUN, Aspartate aminotransferase: AST, Alanine aminotransferase: ALT, Alkaline phosphatase: ALP, Erythrocyte sedimentation rate: ESR, White blood cell: WBC, Platelet: PLT, Hemoglobin: HB, Bone marrow: BM, Lactate dehydrogenase: LDH, Creatinine: Cr.