No abstract available.
beta-Thalassemia* ; Chelation Therapy* ; Humans ; Iron Overload* ; Iron*

OBJECTIVETo explore the effect of chelation therapy with succimer (DMSA) in male rabbits of moderate lead poisoning during juvenile stage.

METHODSTwenty-four 45-day-old male New Zealand rabbits were randomly divided into three groups (therapy group, TG; positive control group, PG and negative control group, NG, n=8). The TG and PG were orally exposed to lead acetate (5 mg x kg(-1) x d(-1)) for 6 weeks. Rabbits in TG were orally supplied DMSA 1050 mg/m2 in the first week and 700 mg/m2 in the next two weeks, while the other two groups wren't blood and urinary samples of all rabbits were collected per week. The tissues and organs of all rabbits were collected after 12 weeks. The blood lead levels (BLLs) were determined by atomic absorption spectrometer. The urine lead levels and the lead contents of tissue and organ were determined by inductively coupled plasma-mass spectrometry. Histopathology of tissue and organ was observed by light microscope.

RESULTSCompared with PG, the lead level in the morning urine of TG with DMSA chelating was increased significantly. The level was peaked at (1246.96 +/- 157.91) microg/L on the first day after chelating. While the base line was (40.97 +/- 1.77) microg/L before chelating. Meanwhile, the BLLs were sharply declined from (429.63 +/- 10.82) microg/L to (238.50 +/- 11.82) microg/L. The urine lead levels of TG decreased through the 3-week chelating and 3-week discontinuation. The urine lead levels of these two groups were significantly different (F=2934.35, P<0.01). Compared to each two groups in these three groups, there were significant difference (P<0.01). The authors found the reversion of BLLs in first week after stop chelating. The BLLs of PG presented the slow course of declining in the same time, were (135.50 +/- 7.09) microg/L, very close to the level of TG for (149.88 +/- 11.39) microg/L. Compared with treatment discontinuation for 3 weeks, the urine lead levels and the body weight gain of the therapy group increased more than that of PG, and the BLLs and the lead concentrations in tissues and organs decreased more than that of PG, and histopathology in the liver tissues and testicle tissues were improved.

CONCLUSIONDMSA chelating for the rodent models of moderate lead poisoning might reduce the BLLs and soft tissue lead contents quickly and effectively, decrease toxic effects of lead in a short period of time, thus alleviate the impairment of lead poisoning on tissues and organs by decreasing lead burden, and bring out improvement on the growth retardation caused by lead poisoning.

Animals ; Chelation Therapy ; Lead ; blood ; urine ; Lead Poisoning ; drug therapy ; Male ; Rabbits ; Succimer ; therapeutic use

We describe a patient with sensory polyneuropathy and cobalt intoxication. The cause of cobalt intoxication was metallosis of a metal-on-metal hip joint composed of cobalt-chrome alloy. A nerve conduction study revealed axonal sensory polyneuropathy, which improved slightly after chelation therapy and revision surgery. This case implies that a history of arthroplasty should not be neglected in the context of sensory polyneuropathy.
Alloys ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Axons ; Chelation Therapy ; Cobalt* ; Hip Joint ; Humans ; Neural Conduction ; Polyneuropathies*

The differential diagnosis of chorea can be challenging in patients without a family history of Huntington's disease or acute-onset hemichorea with stroke. A 50-year-old woman presented with generalized choreic movements and gait disturbance that first appeared 1 month previously. An extensive diagnostic workup including genetic testing, neuroimaging, and various laboratory investigations revealed that this patient had developed chorea as a result of mercury poisoning. She was treated successfully with chelation therapy.
Chelation Therapy ; Chorea ; Diagnosis, Differential ; Female ; Gait ; Genetic Testing ; Humans ; Huntington Disease ; Mercury Poisoning ; Neuroimaging ; Stroke

The differential diagnosis of chorea can be challenging in patients without a family history of Huntington's disease or acute-onset hemichorea with stroke. A 50-year-old woman presented with generalized choreic movements and gait disturbance that first appeared 1 month previously. An extensive diagnostic workup including genetic testing, neuroimaging, and various laboratory investigations revealed that this patient had developed chorea as a result of mercury poisoning. She was treated successfully with chelation therapy.
Chelation Therapy ; Chorea ; Diagnosis, Differential ; Female ; Gait ; Genetic Testing ; Humans ; Huntington Disease ; Mercury Poisoning ; Neuroimaging ; Stroke

We present a case of beta-propeller protein-associated neurodegeneration, a form of neurodegeneration with brain iron accumulation. The patient harbored a novel mutation in the WDR45 gene. A detailed video and description of her clinical condition are provided. Her movement disorder phenomenology was characterized primarily by limb stereotypies and gait dyspraxia. The patient's disability was advanced by the time iron-chelating therapy with deferiprone was initiated, and no clinical response in terms of cognitive function, behavior, speech, or movements were observed after one year of treatment.
Brain ; Chelation Therapy ; Cognition ; Extremities ; Gait Apraxia ; Humans ; Iron ; Movement Disorders

This is a case of 27-year-old male who sustained multiple metallic embolism from non-accidental self-injection of elemental mercury through the intravenous route. The patient allegedly self-injected at least twenty thermometers' worth of elemental mercury in a span of one year. The patient presented with generalized body fatigue, difficulty in position sense, distal hand weakness, tremors, labile mood, insomnia, and emotional instability. Physical examination showed multiple subcutaneous granulomas in the extremities at the sites of elemental mercury injection. Radiographic studies in the lungs, abdomen and extremities showed multiple dense spherules and pinpoint opacities indicative of metallic mercury embolism. Serum mercury levels were elevated. The patient underwent multiple hemodialysis sessions due to acute renal failure and tubular nephropathy secondary to mercury poisoning. The patient was eventually referred to the anesthesia department for excision of foreign body granulomas. Fentanyl, Propofol, Atracurium and Sevoflurane were used to induce and maintain anesthesia. Intra-operative course was unremarkable. Chelation therapy with DMSA (2,3-dimercaptosuccinic acid) was done postoperatively. Serum mercury was undetectable 20 days after surgery and chelation therapy. There were no postoperative complications. The patient was discharged well after 43 days of admission.
Human ; Male ; Adult ; EMBOLISM ; CHELATION THERAPY ; MERCURY POISONING, NERVOUS SYSTEM ; CUSHING SYNDROME

OBJECTIVES: We wanted to investigate the efficacy of dimercaptosuccinic acid (DMSA) for the treatment of lead poisoning in an adult. METHODS: The chelation therapy was applied using oral DMSA after measuring the blood lead and performing, renal function tests, liver tests and a physical examination. This therapy with oral DMSA 30 mg/kg/day was administered three times a day for 5 days to an adult patient with a pre-chelation blood lead concentration of 75 microgram/dL. Testing was performed by assessing the daily blood lead level, the blood ZPP, the urine ALA, the symptoms and side effects were assessed by conducting a physical examination. RESULTS: DMSA therapy given for the duration of 5 days reduced the blood lead concentration from 75 microgram/dL to 21.8 microgram/dL. The blood ZPP concentration fell from 366 microgram/dL to 300 microgram/dL. The urine ALA concentration fell from 9.71 mg/L to 0.38 mg/L. In addition, the symptoms of headache, dizziness and abdominal pain that were induced by lead were improved after 2 days of chelation therapy. The vomiting did not improve after 5 days of chelation therapy, but this resolved 14 days following cessation of therapy. No adverse effects of DMSA therapy were seen. CONCLUSIONS: Oral chelation therapy with DMSA 30 mg/kg/day is possible without being admitted to a hospital and it is generally effective, safe, and relatively inexpensive. DMSA provides a positive effect on adult patients who have lead poisoning.
Abdominal Pain ; Adult ; Chelation Therapy ; Dizziness ; Headache ; Humans ; Lead Poisoning ; Liver Function Tests ; Physical Examination ; Succimer ; Vomiting

BACKGROUND: Although chelation therapy with calcium disodium ethylenediamine tetraacetic acid (CaNa2EDTA) reduces body burden of lead and improves clinical side effects from lead, it is unclear whether long-term repeated chelation is safe for chronic lead poisoning with nephropathy. We described the consequential changes of renal function and clinicopathological findings during one to two years of monthly administration of CaNa2EDTA in patients with chronic lead nephropathy and excessive body lead burden. METHODS: Three patients diagnosed as chronic lead nephropathy received 1 g/day of intravenous CaNa2EDTA for a 3-5 day/cycle. A total of 48-86 g CaNa2EDTA was administered. Midtibial bone lead, chelatable lead, and blood lead levels were assessed. Renal function was determined in each chelation, and renal biopsies before and after chelation were conducted and compared for microscopic and immunofluorescence changes. RESULTS: Cortical bone lead levels showed a high burden of lead (>200 microgram Pb/g bone mineral). During CaNa2EDTA treatment, blood lead level and renal function were in steady state. No evidence of progression of renal pathology was observed in both renal biopsies, showing similar interstitial fibrosis and glomerular sclerosis. CONCLUSION: Our results suggest that long-term repeated chelation therapy with CaNa2EDTA is safe and effective for patients who have suffered from severe chronic lead poisoning, even though renal pathologic change has started.
Biopsy ; Body Burden ; Calcium ; Chelation Therapy* ; Edetic Acid ; Fibrosis ; Fluorescent Antibody Technique ; Humans ; Lead Poisoning ; Pathology ; Sclerosis

BACKGROUND: Mercury poisoning presents a variety of clinical pictures depending on the chemical structure, the route of exposure, the amount absorbed and other individual factors. Therefore, the ingestive and subcutaneous absorption of elemental(metallic) mercury can be considered to be relatively harmless in contrast to the inhalation of mercury vapor. CASE REPORTS: A 72-year-old man presented to the department of urology due to tenderness, edema and a necrotic abscess of his penis after trauma. The soft tissue abscess required a surgical resection of the penis. For chelation therapy, oral D-penicillamine was administrated. 7 months later, he showed no subjective or objective signs of mercury poisoning. Another 5-yearold girl presented to the emergency department after accidental self-ingestion of elemental mercury. She was followed clinically and did not show any systemic mercury poisoning. CONCLUSION: The Mercury concentrations in the blood and urine were elevated in the case of subcutaneous exposure, but was unchanged in the case of ingestion. Subcutaneous and gastrointestinal exposure to metallic mercury has a minimal risk for systemic mercury poisoning, which is in contrast to the exposure by inhalation.
Abscess ; Absorption ; Aged ; Chelation Therapy ; Eating ; Edema ; Emergency Service, Hospital ; Female ; Humans ; Inhalation ; Male ; Mercury Poisoning ; Penicillamine ; Penis ; Urology