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Children with Moderately Elevated Lead Levels: Is Chelation with DMSA Helpful?

Division of General Academic Pediatrics, Rainbow Babies and Children's Hospital, 11100 Euclid Ave., Cleveland, OH 44106-6019; Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio

Deborah Rich, PhD

Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio

This study evaluates the effectiveness (use under routine circumstances) of DMSA (2,3 dimercaptosuccinic acid) and environmental remediation as compared with placebo and environmental remediation on children with blood lead (BPb) levels of 30-45 pg/dL (1.45-2.17 pmol/L). The endpoints were BPb at 1 month and 6 months after study entry. This double-blind placebo-controlled trial involved 39 children aged 2-5 years, who were randomized to one course of DMSA or placebo. The mean BPb levels of the two groups at study entry were similar, placebo group 33.0 pg/dL (1.59 pmol/L) and the DMSA group 34.9 pg/dL (1.68 pmol/L). At 1 month (the end of treatment) the mean BPb levels of the two groups were: placebo group 33.2 pg/dL (1.60 pmol/L) and the DMSA group 27.4 pg/dL (1.32 pmol/L), p=0.16. At 6 months, the mean BPb levels were 25.1 pg/dL (1.21 pmol/L) for the placebo group and 28.8 pg/dL (1.39 pmol/L) for the DMSA-treated group, p=0.06. Neither of these differences is statistically significant. All children with BPb, in the range studied here, should receive environmental evaluation and remediation; DMSA does not improve long-term blood lead levels.

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				G. Rischitelli, P. Nygren, C. Bougatsos, M. Freeman, and M. Helfand Screening for Elevated Lead Levels in Childhood and Pregnancy: An Updated Summary of Evidence for the US Preventive Services Task Force Pediatrics, December 1, 2006; 118(6): e1867 - e1895. [Abstract] [Full Text] [PDF]