Takashi Oshima, MD; Kiyoshi Kinjo, MD, MS; Mitsuyo Kinjo, MD, MPH
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JAMA. 2022;328(2):198-199. doi:10.1001/jama.2022.9194
A 59-year-old man had 3 months of unexplained chronic diffuse abdominal pain. Results of upper and lower endoscopy, abdominal-pelvic CT, and urinalysis were unremarkable; hemoglobin level was 8.7 g/dL; peripheral blood smear showed basophilic stippling of erythrocytes; and physical examination showed bluish pigmentation along the gingival margin. What is the diagnosis and what would you do next?