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Letters |2 November 1999

Treatment of Chronic Lead Intoxication

Ana I. Sanchez-Fructuoso, MD, PhD; Dolores Prats, MD; Alberto Barrientos, MD, PhD

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Author, Article, and Disclosure Information
  • Hospital Clínico Universitario S. Carlos; 28008 Madrid, Spain (Sanchez-Fructuoso)
    Hospital Clínico Universitario S. Carlos; 28008 Madrid, Spain (Prats)
    Hospital Clínico Universitario S. Carlos; 28008 Madrid, Spain (Barrientos)
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TO THE EDITOR:
We read with interest Lin and colleagues' article (1). In a study of approximately 300 patients, our team showed that a high percentage of patients with gout, hypertension, and chronic renal failure had an excessive body lead burden (2). Six patients with EDTA were treated until urine lead excretion decreased below 150 µg/d. All treated patients progressed to end-stage renal disease, and 3 patients subsequently received kidney transplants. The EDTA mobilization test was done on patients who received transplants, and values greater than 1000 µg of lead per 72-hour urine collection were recorded.
An article suggesting that treatment in lead-intoxicated rats could increase lead deposition in the brain (3) led us to refrain from treating the remaining patients who had received a diagnosis of lead intoxication. We then conducted an experimental trial in which 30 rats were intoxicated with low doses of lead. Fifteen rats were subsequently treated with EDTA. The chelating agent reduced levels of lead in the kidney (4.0 ± 0.5 compared with 19.5 ± 2.0 µg/g; P < 0.001), although bone lead deposits were unaffected (39.7 ± 1.9 compared with 40.0 ± 2.5 µg/g; P > 0.2).
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Sanchez-Fructuoso AI, Prats D, Barrientos A. Treatment of Chronic Lead Intoxication. Ann Intern Med. ;131:716. doi: 10.7326/0003-4819-131-9-199911020-00026

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Published: Ann Intern Med. 1999;131(9):716.

DOI: 10.7326/0003-4819-131-9-199911020-00026

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1999 American College of Physicians
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