title: [Treatment of chronic occupational lead poisoning with dimercaptosuccinic acid (DMSA)].
abstract: 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.
authors.affiliation: Medicinsk afdeling C, Odense Universitet.
authors.forename: P
authors.initials: P
authors.lastname: Grandjean
authors.forename: I A
authors.initials: IA
authors.lastname: Jacobsen
authors.forename: P J
authors.initials: PJ
authors.lastname: Jørgensen
authors.forename: S
authors.initials: S
authors.lastname: Lings
authors.forename: O
authors.initials: O
authors.lastname: Andersen
mesh_terms: 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
chemical_list: D004113:Succimer
vernacular_title: Behandling af erhvervsbetinget kronisk blyforgiftning med dimerkaptoravsyre (DMSA).