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

Abstract

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.