Comparison of dimercaptosuccinic acid and calcium disodium ethylenediaminetetraacetic acid versus dimercaptopropanol and ethylenediaminetetraacetic acid in children with lead poisoning

Objectives: To compare the response to dimercaptopropanol (BAL) and calcium disodium ethylenediaminetetraacetic acid (EDTA) versus orally administered meso-2,3-dimercaptosuccinic acid (DMSA) and EDTA in children with lead poisoning. Methods: Retrospective review of medical records of children admitt...

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Bibliographic Details
Published in:The Journal of pediatrics 1997-06, Vol.130 (6), p.966-971
Main Authors: Besunder, James B., Super, Dennis M., Anderson, Roberta L.
Format: Article
Language:English
Subjects:
Alanine Transaminase - blood
Biological and medical sciences
Blood Urea Nitrogen
Chemical and industrial products toxicology. Toxic occupational diseases
Child
Child, Preschool
Creatinine - blood
Edetic Acid - adverse effects
Edetic Acid - therapeutic use
Female
Hemoglobins
Humans
Lead Poisoning - blood
Lead Poisoning - drug therapy
Male
Medical sciences
Metals and various inorganic compounds
Retrospective Studies
Succimer - adverse effects
Succimer - therapeutic use
Toxicology
Vomiting - etiology
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Summary:Objectives: To compare the response to dimercaptopropanol (BAL) and calcium disodium ethylenediaminetetraacetic acid (EDTA) versus orally administered meso-2,3-dimercaptosuccinic acid (DMSA) and EDTA in children with lead poisoning. Methods: Retrospective review of medical records of children admitted to MetroHealth Medical Center with a whole blood lead (BPb) concentration of 2.17 μmol/L (45 μg/dl) or more (or less than 2.17 μmol/L and not a candidate for outpatient oral chelation) and treated with BAL + EDTA or DMSA + EDTA. In each group, the mean BPb values at the end of therapy and at 14 and 33 days after chelation were compared with pretreatment BPb by the Wilcoxon signed-rank test, whereas the Mann-Whitney U test was used to compare percentage change from pretreatment at each follow-up day between the two groups. Results: Twenty-three children received BAL + EDTA and 22 received DMSA + EDTA.The BPb values (mean ± SD) at the end of therapy and at 14 and 33 days after chelation were significantly lower than pretreatment in both groups (BAL + EDTA: 17 ± 10, 34 ± 7, 36 ± 11 vs 58 ± 14 μg/dl, p
ISSN:0022-3476
1097-6833
DOI:10.1016/S0022-3476(97)70285-3