26 Scientific Studies Showing How EDTA Removes Lead From The Body
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NLM database Documents
Record 1
from database: MEDLINE
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- Title
- Chronic industrial exposure to lead in 63 subjects. II. Evaluation of chelation therapy.
- Author
- Strickland GT; Hwang YF; Chang NK; Blackwell RQ
- Address
- Source
- Southeast Asian J Trop Med Public Health, 1976 Dec, 7:4, 569-74
- Abstract
-
Efficacy of chelation therapy with intravenous calcium disodium edetate, oral Ca EDTA, and oral penicillamine was tested in 63 subjects with chronic minimal industrial exposure to lead. All three agents increased the urinary lead excretion. The effect was greatest with intravenous Ca EDTA, next with oral penicillamine and least with oral Ca EDTA. Symptoms, particularly colicky abdominal pain, improved during the period of chelation therapy. Anaemic subjects showed improvements in haematological parameters. It is recommended that subjects with chronic minimal industrial exposure to lead receive chelation therapy. The relative merits of the three agents are discussed.
- Language of Publication
- English
- Unique Identifier
- 77174905
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- MeSH Heading (Major)
- Edetic Acid|AD/*TU; Lead Poisoning|*DT/UR
- MeSH Heading
- Adult; Chronic Disease; Clinical Trials; Comparative Study; Environmental Exposure; Human; Lead|UR; Male; Penicillamine|AD/TU
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE
- ISSN
- 0038-3619
- Country of Publication
- THAILAND
Record 2
from database: MEDLINE
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- Title
- Chelation therapy in lead nephropathy.
- Author
- Morgan JM
- Address
- Source
- South Med J, 1975 Aug, 68:8, 1001-6
- Abstract
-
Although treatment has been well defined for childhood lead poisoning and for industrial lead exposure, the treatment of lead nephropathy has been poorly studied. The available chelating agents are reviewed and the results of treatment in 17 cases of lead nephropathy are shown. It is concluded that lead nephropathy should be recognized early and treated energetically, as this may stabilize or improve renal function. Since EDTA is excreted much like creatinine, the dosage must be reduced proportionately in response to elevated serum creatinine levels in the patient with renal failure.
- Language of Publication
- English
- Unique Identifier
- 76013429
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- MeSH Heading (Major)
- Chelating Agents|*TU; Kidney Diseases|*PA; Lead Poisoning|*DT
- MeSH Heading
- Administration, Oral; Creatinine|BL; Dimercaprol|TU; Drug Eruptions|CI; Drug Therapy, Combination; Edetic Acid|AD/AE/TU; Human; Hypocalcemia|CI; Infusions, Parenteral; Injections, Intramuscular; Injections, Intravenous; Kidney Failure, Acute|CI; Lead|UR; Male; Penicillamine|TU; Thrombophlebitis|CI
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0038-4348
- Country of Publication
- UNITED STATES
Record 3
from database: MEDLINE
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- Title
- Aggressive approach in the treatment of acute lead encephalopathy with an extraordinarily high concentration of lead.
- Author
- Gordon RA; Roberts G; Amin Z; Williams RH; Paloucek FP
- Address
- Department of Pharmacy Practice, College of Pharmacy, University of Illinois, Chicago 60612, USA.
- Source
- Arch Pediatr Adolesc Med, 1998 Nov, 152:11, 1100-4
- Abstract
-
OBJECTIVE: To report a case of a 3-year-old child with an extraordinarily massive lead concentration, 26.4 micromol/L (550 microg/dL), following environmental exposure to lead paint in the home. LITERATURE REVIEW: The relevant literature concerning the treatment of lead encephalopathy was reviewed during the treatment of this child and preparation of the manuscript. To our knowledge, the landmark article written by Julian Chisolm in 1968 is the only recent article that reported similarly high levels of lead concentration. This case, however, is the first in which 3 chelating agents were used for the treatment of lead encephalopathy. We also reviewed the literature on the use of whole bowel irrigation in heavy metal intoxications. CONCLUSIONS: In this case, aggressive gut decontamination with whole bowel irrigation and triple chelation therapy with British anti-Lewisite, EDTA, and oral succimer was well tolerated and seemed effective for rapidly deleading the child. The extent to which her lead concentration increased while being treated with oral succimer alone necessitated further chelation with EDTA. Further evaluation is necessary to determine if triple chelation therapy is an appropriate method for severe lead intoxication, and if the use of whole bowel irrigation should be considered in heavy metal intoxication.
- Language of Publication
- English
- Unique Identifier
- 99027427
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- MeSH Heading (Major)
- Brain Diseases|*ET/TH; Iron Chelating Agents|*TU; Lead|*BL; Lead Poisoning|BL/*TH
- MeSH Heading
- Case Report; Child, Preschool; Dimercaprol|TU; Edetic Acid|TU; Environmental Exposure; Female; Human; Irrigation; Paint|PO; Polyethylene Glycols|AD; Succimer|TU
- Publication Type
- JOURNAL ARTICLE; REVIEW; REVIEW OF REPORTED CASES
- ISSN
- 1072-4710
- Country of Publication
- UNITED STATES
Record 4
from database: MEDLINE
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- Title
- The efficacy of chelation therapy and factors influencing mortality in lead intoxicated petrol sniffers.
- Author
- Burns CB; Currie B
- Address
- Clinical Unit, Menzies School of Health Research, Darwin, NT.
- Source
- Aust N Z J Med, 1995 Jun, 25:3, 197-203
- Abstract
-
BACKGROUND: The use of chelating agents to treat patients with petrol sniffing encephalopathy has been controversial, since alkyllead additives in petrol are not chelatable. A high mortality has also been reported in hospitalised petrol sniffers. AIMS: (i) Evaluate the efficacy of chelating agents in mobilising lead for excretion and lowering blood lead; (ii) Review factors contributing to mortality in hospitalised petrol sniffers. METHODS: All males chelated between 1992-1993 were studied (n = 20). Blood and urinary lead were measured daily before and during chelation then twice weekly until discharge. Parenteral calcium disodium edetate (EDTA) and dimercaprol (BAL) were administered together, every six hours for five days, seven patients subsequently received oral D-penicillamine until discharge. Clinical details were reviewed for eight patients with petrol sniffing encephalopathy who died between 1990-1994. RESULTS: Urinary lead excretion substantially increased during parenteral chelation (median excretion = 113 microM/5 days, compared with pre-chelation excretion = 1.1 microM/day). Median blood lead concentration fell from 4.83 microM/L (pre-chelation) to 1.91 microM/L (post-chelation). D-Penicillamine did not appear to increase urinary lead excretion appreciably. All eight deaths followed sepsis; five from complications of aspiration pneumonia. CONCLUSIONS: Airway maintenance and management are crucial for survival in these patients. In the short-term, parenteral chelation was effective in mobilising lead for excretion and reducing blood lead in encephalopathic petrol sniffers and was comparable to cases of inorganic lead intoxication. However, as in the treatment of inorganic lead intoxication, the long-term efficacy of chelation for petrol sniffers remains controversial. Prevention strategies against petrol sniffing at a community level are recommended.
- Language of Publication
- English
- Unique Identifier
- 96078344
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- MeSH Heading (Major)
- Chelating Agents|*TU; Chelation Therapy|*; Dimercaprol|*TU; Edetic Acid|*TU; Gasoline|*; Lead|*/UR; Lead Poisoning|*ET; Substance-Related Disorders|*CO
- MeSH Heading
- Human; Male; Support, Non-U.S. Gov't; Treatment Outcome
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0004-8291
- Country of Publication
- AUSTRALIA
Record 5
from database: MEDLINE
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- Title
- Comparison of dimercaptosuccinic acid and calcium disodium ethylenediaminetetraacetic acid versus dimercaptopropanol and ethylenediaminetetraacetic acid in children with lead poisoning.
- Author
- Besunder JB; Super DM; Anderson RL
- Address
- Department of Pediatrics, MetroHealth Medical Center, Cleveland, OH 44109-1998, USA.
- Source
- J Pediatr, 1997 Jun, 130:6, 966-71
- Abstract
-
OBJECTIVES: To compare the response to dimercaptopropanol (BAL) and calcium disodium ethylenediaminetetraacetic acid (EDTA) versus orally administered meso-2,3-dimercaptosuccinic acid (DMSA) and EDTA in children with lead poisoning. METHODS: Retrospective review of medical records of children admitted to MetroHealth Medical Center with a whole blood lead (BPb) concentration of 2.17 mumol/L (45 micrograms/dl) or more (or less than 2.17 mumol/L and not a candidate for outpatient oral chelation) and treated with BAL + EDTA or DMSA + EDTA. In each group, the mean BPb values at the end of therapy and at 14 and 33 days after chelation were compared with pretreatment BPb by the Wilcoxon signed-rank test, whereas the Mann-Whitney U test was used to compare percentage change from pretreatment at each follow-up day between the two groups. RESULTS: Twenty-three children received BAL + EDTA and 22 received DMSA + EDTA. The BPb values (mean +/- SD) at the end of therapy and at 14 and 33 days after chelation were significantly lower than pretreatment in both groups (BAL + EDTA: 17 +/- 10, 34 +/- 7, 36 +/- 11 vs 58 +/- 14 micrograms/dl, p < 0.02, 0.01, 0.001, respectively; DMSA + EDTA: 10 +/- 4, 30 +/- 10, 30 +/- 14 vs 50 +/- 10 micrograms/dl, p < 0.01, 0.001, 0.01, respectively). The percentage reduction (mean +/- SD) in BPb from pretreatment at the end of therapy and on days 14 and 33 after chelation did not differ between the groups (BAL + EDTA: -71.2% +/- 19.8%, -40.2% +/- 13.8%, -37.1% +/- 17%; DMSA + EDTA: -79.9% +/- 8.7%, -38.3% +/- 21.6%, -37% +/- 32%; p > 0.20). Elevation of alanine aminotransferase and vomiting during therapy were observed more frequently in the BAL + EDTA group compared with the DMSA + EDTA group. CONCLUSIONS: Treatment with DMSA or BAL combined with EDTA results in a comparable reduction in BPb.
- Language of Publication
- English
- Unique Identifier
- 97346201
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- MeSH Heading (Major)
- Edetic Acid|AE/*TU; Lead Poisoning|BL/*DT; Succimer|AE/*TU
- MeSH Heading
- Alanine Transaminase|BL; Blood Urea Nitrogen; Child; Child, Preschool; Comparative Study; Creatinine|BL; Female; Hemoglobins; Human; Male; Retrospective Studies; Vomiting|ET
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0022-3476
- Country of Publication
- UNITED STATES
Record 6
from database: MEDLINE
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- Title
- Provocative chelation with DMSA and EDTA: evidence for differential access to lead storage sites.
- Author
- Lee BK; Schwartz BS; Stewart W; Ahn KD
- Address
- Institute of Industrial Medicine, Soonchunhyang University, Chunan, Republic of Korea.
- Source
- Occup Environ Med, 1995 Jan, 52:1, 13-9
- Abstract
-
OBJECTIVES--To validate a provocative chelation test with 2,3-dimercaptosuccinic acid (DMSA) by direct comparison with the standard ethylene diamine tetraacetic acid (EDTA) test in the same subjects; and to compare and contrast the predictors of lead excretion after DMSA with those after EDTA. A metal chelating agent given orally, DMSA may mobilise and enhance the excretion of lead from the storage sites in the body that are most directly relevant to the health effects of lead. A provocative chelation test with DMSA could thus have wide potential application in clinical care and epidemiological studies. METHODS--34 male lead workers in the Republic of Korea were given a single oral dose of 10 mg/kg DMSA, urine was collected over the next eight to 24 hours, and urine volume and urinary lead concentration determined at 0, 2, 4, 6, 8, and 24 hours. Either two weeks before or two weeks after the dose of DMSA 17 of these workers also received 1 g intravenous EDTA followed by an eight hour urine collection with fractionation at 0, 2, 4, 6, and 8 hours. RESULTS--Urinary lead concentration peaked at two hours after DMSA and four hours after EDTA. Lead excretion after DMSA was less than after EDTA, and cumulative excretion after DMSA plateaued at six to eight hours. The two hour and four hour cumulative lead excretions after DMSA were highly correlated with the eight hour total (r = 0.76 and 0.95). In multiple linear regression analyses, blood lead was found to be an important predictor of EDTA-chelatable lead, whereas urinary aminolevulinic acid (ALAU) was associated with DMSA-chelatable lead. Notably, lead excretion after DMSA was greatly increased if EDTA was given first. An earlier dose of EDTA also modified the relation between ALAU and DMSA-chelatable lead in that workers who received EDTA before DMSA showed a much steeper dose-response relation between these two measures. CONCLUSIONS--The predictors of lead excretion after DMSA and EDTA are different and an earlier dose of EDTA may increase lead excretion after a subsequent dose of DMSA. The results suggest that two hour or four hour cumulative lead excretion after DMSA may provide an estimate of lead in storage sites that are most directly relevant to the health effects of lead.
- Language of Publication
- English
- Unique Identifier
- 95211216
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- MeSH Heading (Major)
- Chelation Therapy|*; Edetic Acid|*TU; Lead|*; Occupational Exposure|*; Succimer|*TU
- MeSH Heading
- Adult; Comparative Study; Dose-Response Relationship, Drug; Environmental Monitoring; Human; Korea; Male; Middle Age; Time Factors
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
- ISSN
- 1351-0711
- Country of Publication
- ENGLAND
Record 7
from database: MEDLINE
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- Title
- A ceramic glazer presenting with extremely high lead levels.
- Author
- Ooi DS; Perkins SL
- Address
- Division of Biochemistry, Ottawa Civic Hospital, Ontario, Canada.
- Source
- Hum Toxicol, 1988 Mar, 7:2, 171-4
- Abstract
-
A case of lead poisoning in a ceramic glazer is reported. The patient had an extremely high level of blood lead at 29.5 mumol/l, and many of the laboratory features of lead toxicity: normocytic anaemia with marked basophilic stippling, abnormal blood and urinary porphyrins, and elevated liver enzymes. Surprisingly, the patient had no electromyographic evidence of neurologic involvement. The patient was treated with intravenous EDTA-calcium followed by oral penicillamine. Urinary porphyrin and porphyrin precursor excretion followed an interesting pattern, correlating with the chelator used. This patient illustrates that extremely high blood lead level can be achieved through the oral route in an adult.
- Language of Publication
- English
- Unique Identifier
- 88243195
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- MeSH Heading (Major)
- Ceramics|*; Lead|*BL; Lead Poisoning|*BL/DI/DT; Occupational Diseases|*BL/DI/DT
- MeSH Heading
- Adult; Calcium|TU; Case Report; Coproporphyrins|AN; Edetic Acid|TU; Female; Human; Penicillamine|TU
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0144-5952
- Country of Publication
- ENGLAND
- CAS Registry/EC Number
- 0 (Ceramics); 0 (Coproporphyrins); 52-67-5 (Penicillamine); 60-00-4 (Edetic Acid); 7439-92-1 (Lead); 7440-70-2 (Calcium)
Record 8
from database: MEDLINE
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- Title
- Meso-2,3-dimercaptosuccinic acid in the diagnosis and treatment of lead poisoning.
- Author
- Bentur Y; Brook JG; Behar R; Taitelman U
- Address
- Source
- J Toxicol Clin Toxicol, 1987, 25:1-2, 39-51
- Abstract
-
Lead poisoning remains one of the hazards of industrialized civilization. CaNa2 EDTA and dimercaprol, the usual therapeutic measures, have many side effects and can be given by parenteral route alone. The authors present a case of chronic lead poisoning caused by ingestion of contaminated flour ground in a primitive flour mill. The diagnosis was confirmed by the CaNa2 EDTA provocative test. Dimercaptosuccinic acid (DMSA) was given orally as a further provocation and resulted in an 11-fold increase in urinary lead excretion. A 5-day course of treatment with DMSA was instituted, during which symptoms abated, urinary lead excretion increased and the blood lead level decreased. No side effects were noticed. There has been no relapse over several months of follow-up. The authors conclude that the oral use of DMSA is effective, safe and convenient both as a provocative test in establishing the diagnosis of lead poisoning and as a therapeutic tool.
- Language of Publication
- English
- Unique Identifier
- 87226310
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- MeSH Heading (Major)
- Lead Poisoning|DI/*DT; Succimer|DU/*TU; Sulfhydryl Compounds|*TU
- MeSH Heading
- Adult; Bread; Case Report; Edetic Acid|DU; Food Contamination; Human; Lead|UR; Male
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0731-3810
- Country of Publication
- UNITED STATES
- CAS Registry/EC Number
- 0 (Sulfhydryl Compounds); 304-55-2 (Succimer); 60-00-4 (Edetic Acid); 7439-92-1 (Lead)
Record 9
from database: MEDLINE
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- Title
- Management of childhood lead poisoning: a survey [see comments]
- Author
- Glotzer DE; Bauchner H
- Address
- Department of Pediatrics, Boston City Hospital, MA 02118.
- Source
- Pediatrics, 1992 Apr, 89:4 Pt 1, 614-8
- Abstract
-
Published recommendations (1985) for the management of childhood lead poisoning suggest the use of ethylenediaminetetraa cetic acid (EDTA) provocation testing and chelation as the mainstay of treatment for blood lead levels between 25 and 55 micrograms/dL. Since 1985 evidence has accumulated indicating that (1) levels of blood lead less than 25 micrograms/dL are detrimental to cognitive development, (2) EDTA provocation testing may result in potentially harmful shifts in the body lead burden, and (3) oral agents such as penicillamine and 2,3-dimercaptosuccinic acid are effective in reducing elevated lead levels. To determine how this evidence impacts on the management of childhood lead poisoning, the authors surveyed the lead poisoning clinics of pediatric departments in the cities estimated by the United States Public Health Service to have the largest number of children affected by lead poisoning. Thirty (70%) of 43 surveys were completed. Respondents indicated that the lowest blood lead level for which they would use a chelating agent to reduce the lead burden was as follows: 50 micrograms/dL (3%), 45 micrograms/dL (3%), 40 micrograms/dL (13%), 35 micrograms/dL (3%), 30 micrograms/dL (27%), 25 micrograms/dL (47%), and 20 micrograms/dL (3%). For all blood lead levels from 20 through 55 micrograms/dL, EDTA was the most frequently recommended chelating agent (chelation and provocation testing). Fifteen percent of responding lead clinics do not use the provocation test under any circumstances. For a child with a negative EDTA provocation test, the percentage of respondents recommending the use of any chelation therapy ranged from 16% for blood lead levels of 25 through 29 micrograms/dL to 66% for levels of 50 through 55 micrograms/dL.(ABSTRACT TRUNCATED AT 250 WORDS)
- Language of Publication
- English
- Unique Identifier
- 92212631
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- MeSH Heading (Major)
- Chelating Agents|*TU; Lead Poisoning|BL/*DT
- MeSH Heading
- Child; Clinical Protocols; Drug Utilization; Edetic Acid|DU/TU; Human; Lead|BL; Penicillamine|TU; Succimer|TU; Support, U.S. Gov't, P.H.S.; United States
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0031-4005
- Country of Publication
- UNITED STATES
- CAS Registry/EC Number
- 0 (Chelating Agents); 304-55-2 (Succimer); 52-67-5 (Penicillamine); 60-00-4 (Edetic Acid); 7439-92-1 (Lead)
Record 10
from database: MEDLINE
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- Title
- Lead poisoning with pigmentation of the oral mucosa. Review of the literature and report of a case.
- Author
- ten Bruggenkate CM; Lopes Cardozo E; Maaskant P; van der Waal I
- Address
- Source
- Oral Surg Oral Med Oral Pathol, 1975 May, 39:5, 747-53
- Abstract
-
Some general aspects of the pathogenesis and the clinical and oral symptoms of chronic lead intoxication are presented. Treatment procedures are briefly discussed. The case of a patient suffering from plumbism is described. A typical Burtonian line was present in the mouth. By electron microprobe analysis, it was shown that this line was mainly the result of lead and, to a minor extent, the result of mercury-, copper-, and iron-bearing pigment in the subepithelial tissue.
- Language of Publication
- English
- Unique Identifier
- 75195263
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- MeSH Heading (Major)
- Gingival Diseases|*CI; Lead Poisoning|*CO/DI/DT; Pigmentation Disorders|*CI
- MeSH Heading
- Adult; Biopsy; Calcium|AD/TU; Edetic Acid|AD/TU; Human; Injections, Intravenous; Male
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0030-4220
- Country of Publication
- UNITED STATES
Record 11
from database: MEDLINE
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- Title
- Lead poisoning. A comprehensive review and report of a case.
- Author
- Gordon NC; Brown S; Khosla VM; Hansen LS
- Address
- Source
- Oral Surg Oral Med Oral Pathol, 1979 Jun, 47:6, 500-12
- Abstract
-
Lead, a ubiquitous heavy metal which has realized increased use, can cause poisoning by environmental contamination in either its organic or its inorganic form. Lead poisoning can be either acute or chronic, with the latter being the more common. The clinical signs and symptoms of lead poisoning are nonspecific, resulting in a difficult diagnostic problem, especially when it is not industrially related. On occasions, the dentist or oral surgeon may be the first to see an afflicted patient because of oral manifestations.
- Language of Publication
- English
- Unique Identifier
- 79179332
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- MeSH Heading (Major)
- Lead Poisoning|*/BL/CO/DI/DT/ET/ME/UR
- MeSH Heading
- Adult; Anemia|ET; Case Report; Child; Diagnosis, Differential; Dimercaprol|TU; Edetic Acid|TU; Gingival Hyperplasia|ET; Hair|AN; Hematopoiesis|DE; Heme|BI; Hemolysis|DE; Human; Kidney|DE; Lead|AN/ME/PD; Male; Occupational Diseases|ET; Penicillamine|TU; Peripheral Nerves|DE
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0030-4220
- Country of Publication
- UNITED STATES
Record 12
from database: MEDLINE
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- Title
- Lead, zinc, and erythrocyte delta-aminolevulinic acid dehydratase: relationships in lead toxicity.
- Author
- Thomasino JA; Zuroweste E; Brooks SM; Petering HG; Lerner SI; Finelli VN
- Address
- Source
- Arch Environ Health, 1977 Nov, 32:6, 244-7
- Abstract
-
A lead-intoxicated patient with extremely high blood lead levels and unexpectedly mild symptoms was studied prior to and following treatment with calcium disodium edetate (ethylenediaminetetraacetic acid) and then prior to and following oral administration of zinc sulfate. During chelation therapy, erythrocyte (delta)-aminolevulinic acid dehydratase (ALAD) activity decreased as blood lead levels fell. Urinary excretion of zinc increased and was more than 3.5 times greater than that of lead. The ratio of blood lead to serum zinc was greatest (1.47) when ALAD activity was lowest. Oral administration of zinc sulfate following chelation therapy resulted in a significant increase in mean ALAD activity. In vitro additions of zinc chloride to the patient's erythrocytes resulted in reactivation of ALAD activity. These studies suggest that zinc is an important element in the ALAD system in man. Zinc may play a protective role in lead toxicity, and zinc supplementation may be a useful adjunct to chelation therapy for lead toxicity.
- Language of Publication
- English
- Unique Identifier
- 78059355
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- MeSH Heading (Major)
- Erythrocytes|*EN; Lead Poisoning|*BL/DT; Porphobilinogen Synthase|*BL; Zinc|*AD/BL/UR
- MeSH Heading
- Adult; Edetic Acid|TU; Human; Lead|BL/UR
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0003-9896
- Country of Publication
- UNITED STATES
Record 13
from database: MEDLINE
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- Title
- Treatment of lead poisoning by 2,3-dimercaptosuccinic acid.
- Author
- Friedheim E; Graziano JH; Popovac D; Dragovic D; Kaul B
- Address
- Source
- Lancet, 1978 Dec, 2:8102, 1234-6
- Abstract
-
2,3-Dimercaptosuccinic acid (D.M.S.), a new orally effective agent for the treatment of heavy-metal intoxication, was administered to five lead-poisoned smelter workers for six days at dosages ranging from 8.4--12.7 mg/kg/day on the first day to 28.1--42.2 mg/kg/day on the last day. Mean blood-lead concentration decreased significantly from an initial value of 97 +/- 6 microgram/dl to 43 +/- 4 microgram/dl on the last day. Urinary lead excretion was significantly raised. D.M.S. was very well tolerated with no signs of toxicity and no effect on urinary zinc, calcium, magnesium, or iron excretion. Urinary copper excretion was significantly increased, but the magnitude of that effect was not clinically important. D.M.S. seems to be safe and effective for the treatment of lead poisoning.
- Language of Publication
- English
- Unique Identifier
- 79071778
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- MeSH Heading (Major)
- Lead Poisoning|*DT; Succimer|*AD; Sulfhydryl Compounds|*AD
- MeSH Heading
- Administration, Oral; Adult; Chemistry; Comparative Study; Drug Administration Schedule; Drug Evaluation; Edetic Acid|AD; Human; Injections, Intravenous; Lead|ME; Metallurgy; Middle Age
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0140-6736
- Country of Publication
- ENGLAND
Record 14
from database: MEDLINE
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- Title
- The effect of succimer therapy in lead intoxication using postural balance as a measure: a case study in a nine year old child.
- Author
- Bhattacharya A; Smelser DT; Berger O; Shukla R; Medvedovic M
- Address
- Biomechanics-Ergonomics Research Laboratory, University of Cincinnati Medical School, OH, USA.
- Source
- Neurotoxicology, 1998 Feb, 19:1, 57-64
- Abstract
-
Postural balance testing was used as a measure of the effect of therapy on a 9 year old boy with high lead levels. Following therapy with CaEDTA and succimer, the patient's postural sway responses were comparable to a low-lead (< 10 micrograms/dL) comparison group for 3 out of 4 tests which rely relatively less on the higher centers for balance. This improvement in postural balance may be attributable to the combined influence of pharmacologic and age associated maturational effects. This case study provides suggestive evidence that while chelation therapy can reduce PbB levels quickly, it can also modify gross neuromotor function manifested by postural balance characteristics.
- Language of Publication
- English
- Unique Identifier
- 98159656
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- MeSH Heading (Major)
- Equilibrium|*DE; Lead Poisoning|*DT/*PP; Succimer|*TU
- MeSH Heading
- Administration, Oral; Case Report; Child; Dimercaprol|TU; Drug Administration Schedule; Edetic Acid|TU; Human; Male; Patient Compliance; Support, U.S. Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0161-813X
- Country of Publication
- UNITED STATES
Record 15
from database: MEDLINE
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- Title
- The relationship between iron and lead absorption in humans.
- Author
- Flanagan PR; Chamberlain MJ; Valberg LS
- Address
- Source
- Am J Clin Nutr, 1982 Nov, 36:5, 823-9
- Abstract
-
Approximately 60% of an oral dose of 100 micrograms of 203Pb was retained in 85 fasting subjects with no difference noted between males and females. Body retention was proportional to dose up to 400 micrograms of lead. It was not related to the capacity to absorb iron or to the size of body iron stores, nor was it affected by the simultaneous ingestion of a 10-fold molar excess of iron. The effect of several dietary factors was also determined. Lead retention was lowered by eating food, slightly increased by ingestion of fat, but was unaffected by the administration of lactose or a 10-fold molar excess of zinc, cobalt, or calcium. One chelating agent, ascorbic acid, slightly lowered lead retention, whereas another agent ethylenediaminetetraacetic acid, produced a marked reduction. Several of these results suggest that human gastrointestinal lead absorption behaves differently to that of rodents. In particular, human lead retention was found to be unrelated to iron absorption or to body iron stores.
- Language of Publication
- English
- Unique Identifier
- 83045487
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- MeSH Heading (Major)
- Ferritin|*BL; Iron|*ME; Lead|AD/*ME
- MeSH Heading
- Absorption; Adult; Diet; Dose-Response Relationship, Drug; Drug Interactions; Edetic Acid|PD; Female; Ferric Compounds|AD; Human; Lactose|PD; Male; Sex Factors; Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0002-9165
- Country of Publication
- UNITED STATES
- CAS Registry/EC Number
- 0 (Ferric Compounds); 301-04-2 (lead acetate); 60-00-4 (Edetic Acid); 63-42-3 (Lactose); 7439-89-6 (Iron); 7439-92-1 (Lead); 7705-08-0 (ferric chloride); 9007-73-2 (Ferritin)
Record 16
from database: MEDLINE
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- Title
- Adult lead poisoning.
- Author
- Zatlin GS; Senaldi EM; Bruckheim AH
- Address
- Source
- Am Fam Physician, 1985 Oct, 32:4, 137-43
- Abstract
-
Although the incidence of occupational and adult lead poisoning has declined, the problem still exists. It often goes unrecognized for long periods because of a low index of suspicion compounded by incomplete surveillance of risk populations. Abdominal pain, fatigue and arthralgia are the most frequent symptoms. Anemia, basophilic stippling of red blood cells and hyperuricemia are the most common clues. Diagnosis is based on blood lead levels. Chelation by calcium disodium edetate, followed by oral penicillamine, is the standard treatment.
- Language of Publication
- English
- Unique Identifier
- 86022587
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- MeSH Heading (Major)
- Lead Poisoning|*BL/DT; Occupational Diseases|*BL/CI
- MeSH Heading
- Adult; Aged; Calcium|TU; Case Report; Edetic Acid|TU; Human; Lead|BL; Male; Middle Age; Protoporphyrins|BL
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0002-838X
- Country of Publication
- UNITED STATES
- CAS Registry/EC Number
- 0 (Protoporphyrins); 60-00-4 (Edetic Acid); 7439-92-1 (Lead); 7440-70-2 (Calcium)
Record 17
from database: MEDLINE
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- Title
- Brushing-induced effects with and without a non-fluoride abrasive dentifrice on remineralization of enamel surfaces etched with phosphoric acid.
- Author
- Kuroiwa M; Kodaka T; Kuroiwa M; Abe M
- Address
- Kuroiwa Dental Clinic, Kanagawa, Japan.
- Source
- Caries Res, 1994, 28:5, 309-14
- Abstract
-
The remineralization of acid-etched enamel after brushing with and without a non-fluoride abrasive dentifrice was investigated using scanning electron microscopy after sodium hypochlorite (NaOCl) or ethylenediamine tetra-acetic acid treatment, of the specimens. Ground enamel pieces were etched with 30% phosphoric acid for 60 s and attached to resin plates. They were exposed to the oral environment of 4 subjects for 8 weeks and brushed for 1 min daily. Paste and brushing caused the acid-etched enamel to erode selectively, i.e., deep grooves were formed in the prism peripheral regions, while projections of the prism bodies showing a relatively low density of crystallites were retained. Brushing without dentifrice, on the other hand, caused about 0.5 micron thick pellicle with tag-like structures to cover the etched enamel. Fine mineral granules, presumably derived from saliva and minute fragments of etched crystallites, were precipitated on the enamel surface as a thin layer with the pellicle. These results indicate that daily brushing without dentifrice induces the remineralization of acid-etched enamel by depositing salivary components, while paste brushing will lead to abrasion of the weakened enamel.
- Language of Publication
- English
- Unique Identifier
- 95094178
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- MeSH Heading (Major)
- Acid Etching, Dental|*; Dental Enamel|*DE/*PA; Dentifrices|AD/*TU; Phosphoric Acids|*PD; Tooth Abrasion|*PA; Tooth Remineralization|*; Toothbrushing|*
- MeSH Heading
- Adolescence; Adult; Calcium Phosphates|AD/TU; Child; Crystallography; Dental Deposits|PA; Edetic Acid|PD; Female; Human; Male; Microscopy, Electron, Scanning; Middle Age; Saliva|PH; Sodium Hypochlorite|PD; Tooth Erosion|PA
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0008-6568
- Country of Publication
- SWITZERLAND
Record 18
from database: MEDLINE
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- Title
- Controlled study of meso-2,3-dimercaptosuccinic acid for the management of childhood lead intoxication.
- Author
- Graziano JH; Lolacono NJ; Moulton T; Mitchell ME; Slavkovich V; Zarate C
- Address
- Department of Pharmacology, Columbia University College of Physicians and Surgeons, New York, New York.
- Source
- J Pediatr, 1992 Jan, 120:1, 133-9
- Abstract
-
We examined the efficacy and safety of meso-2,3-dimercaptosuccinic acid (DMSA) in children with markedly elevated blood lead (BPb) concentrations. Among 19 children with BPb concentrations of 50 to 69 micrograms/dl (2.41 to 3.33 mumol/L) who received a 5-day inpatient oral course of DMSA (1050 mg/m2 per day), the mean BPb concentration decreased by 61%; in four who received calcium disodium ethylenediaminetetraacetic acid (CaNa2EDTA) (1000 mg/m2 per day intravenously), it decreased by 45% (p less than 0.0007). Urinary lead excretion was comparable in both groups. Treatment with DMSA was more effective than treatment with CaNa2EDTA in restoring metabolic activity to the heme pathway and was well tolerated even among nine patients who received concomitant iron supplementation and two who had homozygous deficiency of glucose-6-phosphate dehydrogenase. On discharge, these 19 children received either no chelation therapy or DMSA, 350 or 700 mg/m2 per day for 14 days on an outpatient basis. After 14 days the mean BPb values for the no-chelation, low-DMSA, and high-DMSA groups were 73%, 66%, and 50% of the pretreatment values, respectively. We conclude that a 5-day oral course of DMSA is effective in the treatment of children with severe lead poisoning. In addition, on an outpatient basis the administration of DMSA, 700 mg/m2 per day, is capable of delaying the typical rebound in BPb values and should ultimately reduce the need for repeated hospitalizations.
- Language of Publication
- English
- Unique Identifier
- 92113812
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- MeSH Heading (Major)
- Lead Poisoning|BL/*DT/UR; Succimer|AD/*TU
- MeSH Heading
- Administration, Oral; Ambulatory Care; Aminolevulinic Acid|UR; Aminolevulinic Acid Dehydratase|BL; Calcium|UR; Chelating Agents|AD/TU; Child; Child, Preschool; Dimercaprol|AD/TU; Edetic Acid|AD/TU; Erythrocytes|EN; Follow-Up Studies; Human; Infant; Injections, Intravenous; Lead|BL/UR; Safety; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Zinc|UR
- Publication Type
- CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; JOURNAL ARTICLE
- ISSN
- 0022-3476
- Country of Publication
- UNITED STATES
- CAS Registry/EC Number
- EC 4.2.1.24 (Aminolevulinic Acid Dehydratase); 0 (Chelating Agents); 106-60-5 (Aminolevulinic Acid); 304-55-2 (Succimer); 59-52-9 (Dimercaprol); 60-00-4 (Edetic Acid); 7439-92-1 (Lead); 7440-66-6 (Zinc); 7440-70-2 (Calcium)
Record 19
from database: MEDLINE
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- Title
- Evaluation of the potential role of chelation therapy in treatment of low to moderate lead exposures.
- Author
- Chisolm JJ Jr
- Address
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD.
- Source
- Environ Health Perspect, 1990 Nov, 89:, 67-74
- Abstract
-
In the overall long-term management of lead poisoning, chelation therapy can have short-term benefits; however, these benefits must be accompanied by drastic reduction in environmental exposure to lead if therapy is to have any long-term benefit. This discussion is limited to calcium disodium ethylenediaminetetraacetate (CaNa2EDTA), the chelating agent that has been the mainstay of treatment of lead poisoning for the past 38 years, and to meso-2,3-dimercaptosuccinic acid (DMSA), a new and promising oral chelating agent, which is an orphan drug and is currently classified as an investigational new drug by the U.S. Food and Drug Administration. With both drugs, multiple courses of treatment will be needed if any substantial reduction in body lead burden is to be achieved. A major limitation of CaNa2EDTA is the enormous diuresis of zinc that it produces. DMSA produces a comparable diuresis of lead, a greater decrease in blood lead, and has negligible influence on the urinary losses of zinc, copper, iron, and calcium. Limited experience to date in man has revealed no significant adverse side effects of DMSA. In animals, DMSA will promptly reduce the concentration of lead in brain and kidney, in particular. By contrast, similar 5-day courses of CaNa2EDTA do not produce any net reduction in brain lead. This is important, as the brain is the critical organ of the adverse effects of lead in children. If the efficacy of DMSA is to be comprehensively evaluated ethically in children, new and more sensitive neurochemical, electrophysiologic, or other markers must be developed.
- Language of Publication
- English
- Unique Identifier
- 91209346
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- MeSH Heading (Major)
- Chelation Therapy|*; Lead Poisoning|BL/*DT
- MeSH Heading
- Animal; Chelating Agents|TU; Drug Evaluation; Edetic Acid|TU; Human; Lead|BL; Succimer|TU; Support, U.S. Gov't, Non-P.H.S.; Support, U.S. Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL
- ISSN
- 0091-6765
- Country of Publication
- UNITED STATES
- CAS Registry/EC Number
- 0 (Chelating Agents); 304-55-2 (Succimer); 60-00-4 (Edetic Acid); 7439-92-1 (Lead)
Record 20
from database: MEDLINE
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- Title
- Dose-response study of oral 2,3-dimercaptosuccinic acid in children with elevated blood lead concentrations.
- Author
- Graziano JH; Lolacono NJ; Meyer P
- Address
- Department of Pharmacology, Columbia University College of Physicians and Surgeons, New York, NY 10032.
- Source
- J Pediatr, 1988 Oct, 113:4, 751-7
- Abstract
-
2,3-Dimercaptosuccinic acid (DMSA) is an orally effective orphan drug that is more specific and has a wider therapeutic index than other currently available drugs used for lead intoxication. Its investigational use in the United States has been limited to the treatment of men with occupational plumbism. Twenty-one children with blood lead concentrations of 31 to 49 micrograms/dl, who also had a positive calcium disodium edetate (CaNa2EDTA) mobilization test result, were hospitalized for 7 days. Fifteen children were randomly assigned to three groups that received either 350, 700, or 1050 mg/m2/day, respectively, of DMSA in three divided doses daily. A fourth group of six children received conventional treatment with 1000 mg/m2/day of intravenously administered CaNa2EDTA in two divided doses daily. The 1050 mg/m2/day dose of DMSA was significantly more effective than lower doses of DMSA or intravenously administered CaNa2EDTA in reducing blood lead levels and restoring erythrocyte delta-aminolevulinic acid dehydratase activity. Intravenously administered CaNa2EDTA significantly increased the urinary excretion of several essential minerals (zinc, copper, iron, and calcium), whereas DMSA did not. The DMSA was well tolerated and appears extremely promising as a drug that will simplify the management of childhood lead poisoning.
- Language of Publication
- English
- Unique Identifier
- 89011219
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- MeSH Heading (Major)
- Lead Poisoning|*BL/UR; Succimer|*AD; Sulfhydryl Compounds|*AD
- MeSH Heading
- Administration, Oral; Child; Child, Preschool; Comparative Study; Drug Administration Schedule; Edetic Acid|AD; Human; Minerals|UR; Random Allocation; Sensitivity and Specificity; Support, U.S. Gov't, P.H.S.
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0022-3476
- Country of Publication
- UNITED STATES
- CAS Registry/EC Number
- 0 (Minerals); 0 (Sulfhydryl Compounds); 304-55-2 (Succimer); 60-00-4 (Edetic Acid)
Record 21
from database: MEDLINE
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- Title
- Lead poisoning from contaminated flour in a family of 11 members.
- Author
- Koçak R; Anarat A; AltintaA G; Evliyaoglu N
- Address
- Department of Internal Medicine, Cukurova University Medical School, Adana, Turkey.
- Source
- Hum Toxicol, 1989 Sep, 8:5, 385-6
- Abstract
-
Eleven members of a family living in southeastern Turkey are presented. They were diagnosed as suffering from 'lead poisoning' with typical clinical manifestations and high blood lead concentrations. Contaminated flour (665 micrograms Pb/g) was the cause of poisoning, by oral ingestion. The source of contamination was sought and it was found that the stone of the mill had been repaired with molten lead on the same day that the wheat of the family had been ground; while grinding the wheat some lead was mixed into the flour.
- Language of Publication
- English
- Unique Identifier
- 90034908
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- MeSH Heading (Major)
- Flour|*AN; Food Contamination|*; Lead Poisoning|*/DT
- MeSH Heading
- Adolescence; Adult; Case Report; Child; Child, Preschool; Edetic Acid|TU; Female; Human; Male; Middle Age
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0144-5952
- Country of Publication
- ENGLAND
- CAS Registry/EC Number
- 60-00-4 (Edetic Acid)
Record 22
from database: MEDLINE
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- Title
- Succimer: the first approved oral lead chelator.
- Author
- Jorgensen FM
- Address
- Fairview General Hospital, Cleveland, Ohio.
- Source
- Am Fam Physician, 1993 Dec, 48:8, 1496-502
- Abstract
-
The Centers for Disease Control and Prevention has redefined the threshold of concern for low-level lead toxicity, reducing it from a blood lead level of 25 micrograms per dL (1.21 mumol per L) to a blood lead level of 10 micrograms per dL (0.48 mumol per L), and has recommended universal screening of young children. Succimer (2,3-dimercaptosuccinic acid) is an effective oral lead chelating agent that has been approved for outpatient treatment of children with blood lead levels higher than 45 micrograms per dL (2.17 mumol per L). In the United States, clinical experience with succimer is limited; however, observed side effects, including gastrointestinal symptoms, rash and transient elevations of serum aminotransferase levels, are uncommon and mild. Isolated cases of neutropenia have been reported. Weekly monitoring of complete blood counts and serum aminotransferase levels is recommended during the 19-day treatment. Blood lead levels should be checked weekly to identify rebound from bone and soft tissue mobilization.
- Language of Publication
- English
- Unique Identifier
- 94070584
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- MeSH Heading (Major)
- Lead Poisoning|BL/*DT/EP/PC/UR; Succimer|PD/*TU
- MeSH Heading
- Administration, Oral; Ambulatory Care; Aminotransferases|BL; Clinical Trials; Drug Costs; Drug Eruptions|ET; Drug Monitoring; Edetic Acid|TU; Female; Gastrointestinal Diseases|CI; Human; Mass Screening; Metabolic Clearance Rate; Neutropenia|CI; Pregnancy; United States; United States Food and Drug Administration
- Publication Type
- JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL
- ISSN
- 0002-838X
- Country of Publication
- UNITED STATES
- CAS Registry/EC Number
- EC 2.6.1. (Aminotransferases); 304-55-2 (Succimer); 60-00-4 (Edetic Acid)
Record 23
from database: MEDLINE
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- Title
- An oral treatment for lead toxicity [see comments]
- Author
- Thomas PS; Ashton C
- Address
- Northwick Park Hospital, Harrow, Middlesex, UK.
- Source
- Postgrad Med J, 1991 Jan, 67:783, 63-5
- Abstract
-
Chronic lead poisoning has traditionally been treated by parenteral agents. We present a case where a comparison of ethylene diaminetetra-acetic acid was made with 2,3-dimethyl succinic acid (DMSA) which has the advantage of oral administration associated with little toxicity and appeared to be at least as efficacious.
- Language of Publication
- English
- Unique Identifier
- 91279604
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- MeSH Heading (Major)
- Antidotes|AD/*TU; Edetic Acid|AD/*TU; Lead Poisoning|CO/*DT; Succinates|*TU
- MeSH Heading
- Administration, Oral; Case Report; Chronic Disease; Comparative Study; Epilepsy, Tonic-Clonic|CI; Human; Male; Middle Age
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0032-5473
- Country of Publication
- ENGLAND
- CAS Registry/EC Number
- 0 (Antidotes); 0 (Succinates); 13545-04-5 (2,3-dimethylsuccinic acid); 60-00-4 (Edetic Acid)
Record 24
from database: MEDLINE
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- Title
- Tetracyclines inhibit human synovial collagenase in vivo and in vitro.
- Author
- Greenwald RA; Golub LM; Lavietes B; Ramamurthy NS; Gruber B; Laskin RS; McNamara TF
- Address
- Source
- J Rheumatol, 1987 Feb, 14:1, 28-32
- Abstract
-
To determine if tetracyclines can inhibit human synovial collagenase from rheumatoid tissue, paired synovial tissue (or synovial fluid) was collected from 7 patients before and after oral administration of minocycline (100 mg BID) for 10 days. With each patient serving as his own control, the postminocycline collagenase activities fell an average of 67% from pretreatment values. Qualitative SDS-PAGE revealed decreased loss of alpha collagen components and reduced formation of alpha A digestion fragments. Addition of minocycline or a chemically modified tetracycline to synovial culture media in vitro profoundly inhibited collagenase activity. Further study of this action of tetracyclines could serve as a probe of the role of collagenase in rheumatoid arthritis and lead to development of agents capable of modifying the tissue destructive actions of collagenase.
- Language of Publication
- English
- Unique Identifier
- 87198535
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- MeSH Heading (Major)
- Microbial Collagenase|*AI/ME; Minocycline|*PD; Synovial Fluid|DE/*EN; Synovial Membrane|DE/*EN; Tetracyclines|*PD
- MeSH Heading
- Arthritis, Rheumatoid|EN; Edetic Acid|PD; Human; In Vitro; Support, U.S. Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0315-162X
- Country of Publication
- CANADA
- CAS Registry/EC Number
- EC 3.4.24.3 (Microbial Collagenase); 0 (Tetracyclines); 10118-90-8 (Minocycline); 60-00-4 (Edetic Acid)
Record 25
from database: MEDLINE
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- Title
- A study of the odontoblast process with transmission electron microscopy.
- Author
- White RK; Senia ES; Zislis T; Fox LT; Zeagler JW
- Address