title: New approaches for treatment of humans exposed to a slowly excreted environmental chemical (chlordecone).
abstract: Workers in a small factory that manufactured the organochlorine pesticide chlordecone were exposed to large amounts of this toxic material for many months. Toxic manifestations prominently involved the nervous system, liver and testes. Chlordecone was present in high concentrations in samples of blood, liver, and fat from these workers. A plasmaphoresis experiment indicated that chlordecone is rapidly transferred from tissues to blood. However, hemoperfusion was unsuccessful for removing chlordecone from the body because chlordecone is avidly bound by plasma proteins. Based on the observation that stool contains only a small fraction of the substantial amounts of chlordecone excreted in bile, we administered orally cholestyramine, a nonabsorbable resin that binds chlordecone in vitro. Cholestyramine increased fecal excretion of chlordecone and accelerated the rate of disappearance of the pesticide from the body. This was accompanied by amelioration of the clinical manifestations of toxicity, indicating that the subacute toxic effects of chlordecone are reversible. We conclude that therapy with binding agents taken orally provide a safe and effective means for treatment of humans poisoned with chlordecone and, possibly with other organochlorine pesticides.
mesh_terms: D000273:Adipose Tissue / Q000032:analysis; D007631:Chlordecone / Q000009:adverse effects* / Q000032:analysis / Q000378:metabolism; D002792:Cholestyramine Resin / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007306:Insecticides / Q000009:adverse effects*; D008452:Maximum Allowable Concentration; D009784:Occupational Diseases / Q000139:chemically induced* / Q000188:drug therapy / Q000378:metabolism; D010956:Plasmapheresis
chemical_list: D007306:Insecticides; D002792:Cholestyramine Resin; D007631:Chlordecone