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Clinical Pediatrics, Vol. 31, No. 7, 386-390 (1992)
DOI: 10.1177/000992289203100701

CaEDTA vs CaEDTA Plus BAL to Treat Children with Elevated Blood Lead Levels

Mary E. O'Connor, M.D., M.P.H.

Division of General Academic Pediatrics, Rainbow Babies and Childrens Hospital, Case Western Reserve University, Cleveland, 0H 44106

The effectiveness of CaEDTA alone vs CaEDTA plus BAL was compared retrospectively in a group of 72 children with lead levels between 2.41 µmol/L (50 µg/dL) and 2.90 µmol/L (60 µg/dL). The children who received both drugs had higher median zinc protoporphyrin (ZnP) concentrations at the initiation of therapy than children who received CaEDTA alone (160 µg/dL vs 96 µg/dL, p <.01). There was a significantly increased incidence of vomiting and abnormal liver-function test results in the children who received both drugs. The children who received CaEDTA alone had a greater percent mean fall in lead level at one to three weeks postchelation (30.5 % vs 18.1 %, p <.05). Children who received both CaEDTA and BAL had a greater percent decrease in ZnP at four to eight months postchelation, but there was no difference in percent decrease in lead levels. Children who received both drugs also had a greater number of repeat courses of chelation by six months. The addition of BAL to CaEDTA for treatment of children with lead levels of 2.41 µmol/L (50 µg/dL) to 2.90 µmol/L (60 µg/dL) produced greater toxicity and does not seem to prevent repeat chelations within six months.


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