title: Treatment of chronic lead toxicity with succimer: a case series of 2 adults with retained lead shotgun fragments.
abstract: Few recommendations exist for management of chronic lead toxicity in instances when the source of lead exposure cannot be removed.
  
  
  METHODS
  We describe 2 patients who had shotgun wounds resulting in multiple retained lead pellets. They developed elevated blood lead levels and were treated with 2 weeks of high-dose oral succimer before being placed on maintenance oral succimer therapy with the goal of sustaining suppressed lead levels.
  
  
  CONCLUSIONS
  Retained lead pellets have been associated with increasing blood lead levels over time. Chronic lead toxicity can cause significant morbidity. Few treatments for lead toxicity are available, and there is scarce data on maintenance therapy for patients who have large numbers of retained shotgun pellets.
  
  
  CONCLUSIONS
  This case series documents 2 patients who continue on maintenance oral chelation therapy with succimer in an effort to prevent the sequelae of chronic lead toxicity by maintaining blood lead levels less than 20 μg/dL.
authors.affiliation: From the *Northwestern Memorial Hospital, Chicago, IL; †University of Utah, Salt Lake City; and ‡Intermountain Medical Center, Murray, UT.
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Cyrus
authors.forename: Scott C
authors.initials: SC
authors.lastname: Woller
authors.forename: Mark H
authors.initials: MH
authors.lastname: Stevens
authors.forename: Mary R
authors.initials: MR
authors.lastname: Pugh
authors.forename: Scott M
authors.initials: SM
authors.lastname: Stevens
authors.forename: Corwin Q
authors.initials: CQ
authors.lastname: Edwards
mesh_terms: D000328:Adult; D002614:Chelating Agents / Q000627:therapeutic use*; D005260:Female; D005547:Foreign Bodies / Q000150:complications* / Q000601:surgery; D006801:Humans; D007854:Lead / Q000097:blood; D007855:Lead Poisoning / Q000188:drug therapy*; D008297:Male; D004113:Succimer / Q000627:therapeutic use*; D014948:Wounds, Gunshot / Q000150:complications*
chemical_list: D002614:Chelating Agents; D007854:Lead; D004113:Succimer