In which condition would you find Basophilic stippling in red blood cells?

Basophilic stippling in red blood cells is primarily associated with lead poisoning. This condition occurs due to the presence of lead in the blood, which interferes with various enzymatic processes involved in hemoglobin synthesis. As a result, red blood cells become structurally abnormal, leading to the formation of ribosomal aggregations that manifest as basophilic stippling when stained.

Lead primarily affects the body's ability to produce heme, causing the aforementioned stippling. This is a key diagnostic feature that aids in identifying lead poisoning, especially when seen in peripheral blood smears. The stippling can also indicate an underlying problem with ribosomal function due to lead's toxic effects.

In contrast, while conditions like iron deficiency anemia, hemolytic anemia, and thalassemia can show various abnormalities in red blood cells, they do not typically present with basophilic stippling. Iron deficiency anemia may show microcytic, hypochromic red blood cells, hemolytic anemia can lead to an increase in reticulocyte count and spherocytes, and thalassemia normally presents with microcytic red cells but not stippling. Therefore, basophilic stippling is a hallmark of lead poisoning among these conditions.