Determination by ICP-MS and multivariate data analysis of elemental urine excretion profile during the EDTA chelation therapy: A case study

• Published in: Journal of trace elements in medicine and biology 2020-12, Vol.62, p.126608, Article 126608
• Main Authors: Robotti, Elisa, Quasso, Fabio, Manfredi, Marcello, Gosetti, Fabio, Mazzucco, Eleonora, Isidoro, Ciro, Marengo, Emilio
• Format: Article
• Language: English
• Subjects: Chelation therapy; Elemental profile; ICP-MS; Metal intoxication; Multivariate data analysis; Urine
• ISSN: 0946-672X; 1878-3252
• DOI: 10.1016/j.jtemb.2020.126608

[Display omitted] •The elemental profile in urine is determined for monitoring a chelating therapy.•The analysis allowed to follow metals excretion following the CaNa2EDTA infusion.•The data confirm the efficacy of the chelating therapy in removing heavy metals.•An excretion peak 12–24 h after EDTA infusion is observed for the majority of elements.•Excretion reaches the basal level 24–36 h after the treatment. Based on the medical history and laboratory analytical tests, a patient presenting symptoms compatible with Chronic Fatigue Syndrome was suspected of metal intoxication; therefore, a chelating therapy was attempted. In parallel, the profile of elemental excretion in urine was determined. Chelation therapy by CaNa2EDTA was administered every two weeks and urine samples were routinely collected for 17 months. The samples were mineralized with HNO3 69 % and analyzed by Inductively-Coupled Plasma – Mass Spectrometry. Data were processed by multivariate statistical methods. Most of the toxic elements showed a peak of excretion in 12−24 h after EDTA administration, which returned to basal level by 24−36 h after the treatment. Yet, the excretion of some trace elements persisted in the urine collected 26 h after the treatment. The analysis of excreted metals following the CaNa2EDTA infusion allowed to monitor dynamically the chelation therapy. The chelation therapy was effective in mobilizing and eliminating the principal heavy metals present from the body. However, since such clearance almost vanished 24 h after the treatment, a protocol with more frequent and low-dose administrations is advisable to improve the metal excretion.