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Unanswered questions in metal chelation.

Authors
Kosnett-MJ
Source
J Toxicol Clin Toxicol 1992 Oct; 30(4):529-547
NIOSHTIC No.
00236991
Abstract
Chelation has been shown to increase the urinary excretion of metals, particularly demonstrated with lead (7439921) intoxicated patients. However, the author noted that while increased excretion has been well documented, whether or not the clinical outcome of the patient is improved has not been delineated. Animal studies reveal a very important time dependence to the efficacy of British-Anti- Lewisite (BAL) in averting the lethality of arsenic (7440382). The first clinical use of BAL in humans occurred in individuals suffering from a side effect known as arsenical dermatitis. Patients had a short length of hospital stay when treated with BAL; however, there is no evidence that established neuropathy is improved by the use of BAL. Studies also indicated that chelation therapy increased the urinary excretion of lead (7439921). However, in some studies BAL actually increased the toxicity of lead as well. Use of BAL plus EDTA saw a fall in mortality from lead encephalopathy to less than 5%, but at the same time there were major advances in supportive medical care and the decline in mortality cannot be attributed necessarily to the use of chelation therapy alone. As regards the effect of lead chelation on neurological endpoints in adults, there have been no randomized, placebo controlled, trials. A significant finding is that chelatable lead is not necessarily an indication of a subject's long term lead exposure. The authors ends with a concern about choosing the correct candidates for chelation.
Keywords
NIOSH-Publication; NIOSH-Grant; Cardiovascular-system-disorders; Metal-poisoning; Heavy-metal-poisoning; Lead-poisoning; Arsenic-poisoning; Metal-dusts; Medical-treatment; Chelating-agents; Toxicology
Contact
Medicine University of California, SF Sfgh Bldg 30 5Th Floor San Francisco, CA 94110
CODEN
JTCTDW
CAS No.
7439-92-1; 7440-38-2; 7439-92-1
Publication Date
19921001
Document Type
Journal Article
Funding Amount
162000.00
Funding Type
Grant
Fiscal Year
1993
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-K01-OH-00108
Issue of Publication
4
ISSN
0731-3810
Source Name
Journal of Toxicology: Clinical Toxicology
State
CA
Performing Organization
University of California San Francisco, San Francisco, California
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