[Treatment of chronic occupational lead poisoning with dimercaptosuccinic acid (DMSA)].
2,3-dimercaptosuccinic acid (DMSA) mobilizes lead from superficial depots. In comparison with other chelating agents, DMSA has a high therapeutic index and has the additional advantage that it can be administered orally. We have used DMSA for treatment of chronic occupational lead poisoning in a 54-year old male with signs of neurotoxic effects. The treatment resulted in a rapid decrease in the blood-lead concentration, followed by a slow increase after the treatment and subsequent stabilization at a blood-lead level lower than prior to treatment. During the first course of treatment, almost 100 mumols lead was excreted in the urine. As a result of successive courses of treatments, the patient's condition was improved. However, during the third course of treatment, he developed a mucocutaneous rash which faded again after withdrawal of DMSA; this reaction was subsequently provoked by sub-therapeutic doses, and continued treatment was therefore cancelled. Only minor, reversible side effects of DMSA have hitherto been reported, and DMSA must therefore be regarded a promising agent for long-term, out-patient chelation treatment of chronic lead poisoning.
Grandjean
P
P
Medicinsk afdeling C, Odense Universitet.
Jacobsen
I A
IA
Jørgensen
P J
PJ
Lings
S
S
Andersen
O
O
D006801:Humans; D007855:Lead Poisoning / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced / Q000188:drug therapy*; D004113:Succimer / Q000008:administration & dosage* / Q000009:adverse effects
D004113:Succimer
Behandling af erhvervsbetinget kronisk blyforgiftning med dimerkaptoravsyre (DMSA).