CaEDTA vs CaEDTA plus BAL to treat children with elevated blood lead levels.
The effectiveness of CaEDTA alone vs CaEDTA plus BAL was compared retrospectively in a group of 72 children with lead levels between 2.41 mumol/L (50 micrograms/dL) and 2.90 mumol/L (60 micrograms/dL). The children who received both drugs had higher median zinc protoporphyrin (ZnP) concentrations at the initiation of therapy than children who received CaEDTA alone (160 micrograms/dL vs 96 micrograms/dL, p less than .01). There was a significantly increased incidence of vomiting and abnormal liver-function test results in the children who received both drugs. The children who received CaEDTA alone had a greater percent mean fall in lead level at one to three weeks postchelation (30.5% vs 18.1%, p less than .05). Children who received both CaEDTA and BAL had a greater percent decrease in ZnP at four to eight months postchelation, but there was no difference in percent decrease in lead levels. Children who received both drugs also had a greater number of repeat courses of chelation by six months. The addition of BAL to CaEDTA for treatment of children with lead levels of 2.41 mumol/L (50 micrograms/dL) to 2.90 mumol/L (60 micrograms/dL) produced greater toxicity and does not seem to prevent repeat chelations within six months.
O'Connor
M E
ME
Division of General Academic Pediatrics, Rainbow Babies and Childrens Hospital, Case Western Reserve University, Cleveland, OH 44106.
D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D002614:Chelating Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002675:Child, Preschool; D004112:Dimercaprol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004492:Edetic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006776:Hospitals, Pediatric; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007854:Lead / Q000097:blood; D007855:Lead Poisoning / Q000097:blood / Q000188:drug therapy* / Q000652:urine; D008297:Male; D009820:Ohio / Q000453:epidemiology; D011524:Protoporphyrins / Q000097:blood; D012189:Retrospective Studies; D014839:Vomiting / Q000139:chemically induced / Q000453:epidemiology
D002614:Chelating Agents; D011524:Protoporphyrins; D004112:Dimercaprol; C017803:zinc protoporphyrin; D007854:Lead; D004492:Edetic Acid; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase