Tana Aggressive Lead Treatment w/DMSA THEN EDTA

[Guest guest]

Subject: Fwd: Aggressive Lead Treatment w/DMSA THEN EDTA

Vol. 152 No. 11,

November 1998

Article

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Author/Article Information

Aggressive Approach in the Treatment of Acute Lead Encephalopathy

With an

Extraordinarily High Concentration of Lead

A. Gordon, PharmD; Gerard , MD; Zubair Amin, MD;

H. , PhD; P. Paloucek, PharmD, ABAT

Objective To report a case of a 3-year-old child with an

extraordinarily

massive lead concentration, 26.4 µmol/L (550 µg/dL), following

environmental exposure to lead paint in the home.

Literature Review The relevant literature concerning the treatment of

lead encephalopathy was reviewed during the treatment of this child

and

preparation of the manuscript. To our knowledge, the landmark article

written by n Chisolm in 1968 is the only recent article that

reported similarly high levels of lead concentration. This case,

however,

is the first in which 3 chelating agents were used for the treatment

of

lead encephalopathy. We also reviewed the literature on the use of

whole

bowel irrigation in heavy metal intoxications.

Conclusions In this case, aggressive gut decontamination with whole

bowel irrigation and triple chelation therapy with British anti-

ite,

EDTA, and oral succimer was well tolerated and seemed effective for

rapidly deleading the child. The extent to which her lead

concentration

increased while being treated with oral succimer alone necessitated

further chelation with EDTA. Further evaluation is necessary to

determine

if triple chelation therapy is an appropriate method for severe lead

intoxication, and if the use of whole bowel irrigation should be

considered in heavy metal intoxication.

Arch Pediatr Adolesc Med.. 1998;152:1100-1104

Editor's Note: The unusually severe problem reported in this case

study

should serve as a stark reminder that lead poisoning might be

decreasing,

but it's certainly not gone. D. DeAngelis, MD

Author/Article Information

From the Department of Pharmacy Practice, College of Pharmacy (Drs

Gordon

and Paloucek), the Departments of Medicine (Dr and Paloucek)

and

Pediatrics (Drs and Amin), College of Medicine, University of

Illinois, Chicago; and the Department of Pathology, University of

Illinois Hospital and Clinics, Chicago (Dr ).

Reprints: Paloucek, PharmD, ABAT, Department of Pharmacy

Practice,

College of Pharmacy, University of Illinois, 833 S Wood St, Chicago,

IL

60612.

Accepted for publication May 22, 1998.

We would like to make a special acknowledgment to Honig, MD,

for

his patience and assistance in the completion of the manuscript. His

guidance was invaluable and is greatly appreciated.

© 1998 American Medical Association. All rights reserved.

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[Guest guest]

Thank you. Good info on lead. I have developed some computer connection

problem that I am trying to work out, (I don't know if it is me or my ISP)

so I have not been able to find info on " British anti-ite " which, I

think, they are saying was the 3rd chelator. I have never heard of this. Is

there any experience or knowledge of this med on the list? (Did I read this

wrong?) And, is/was lead a problem with *you* in addition to mercury? As

lead is leaving my daughter, there have been times where if it weren't for

her being " non-verbal, " she seems so NT.

Tana

> Fwd: Aggressive Lead Treatment w/DMSA THEN EDTA

> Vol. 152 No. 11,

> November 1998

> Article

>

> Conclusions In this case, aggressive gut decontamination with whole

> bowel irrigation and triple chelation therapy with British anti-

> ite,

> EDTA, and oral succimer was well tolerated and seemed effective for

> rapidly deleading the child.

[Guest guest]

> Thank you. Good info on lead. I have developed some computer

connection

> problem that I am trying to work out, (I don't know if it is me or

my ISP)

> so I have not been able to find info on " British anti-ite "

which, I

> think, they are saying was the 3rd chelator. I have never heard of

this. Is

> there any experience or knowledge of this med on the list?

Hi Tana,

okay, in my " fuzzy thinking way " I think this has to be BAL

BAL is a chelator that used to be used for --um-- mercury

detox..... I think I have a book or two that talk about it.

I do believe I've read Andy posts that it is not nearly

as effective as ALA.... No surprise there, right?

best wishes,

Moria