Treatment of persons suffering from increased lead resorption with penicillamine
M. Écsy, M. Lászlóffy, T. Kákosy, A. Hudák,
and M. Náray
National Institute of Occupational Health, Budapest, Hungary
CEJOEM 1997, Vol.3. No.4.:329
The classical way of the treatment of the lead poisoning has been the chelating
one with CaNa2EDTA. It is effective, but the adverse effects
are rare and mild. On the other side it can be administered only intravenously
and even in infusion (Chelintox®). This kind of treatment is rather
expensive and bound to institute. That is why the authors tried to find
a cheaper and simplier way of therapy, mainly for the persons suffering
from increased lead resorption without symptoms and signs. Some data of
the literature suggest that the treatment with penicillamine represents
a good alternative of the CaNa2EDTA therapy. Because of the
lack of Hungarian experiences authors compared the lead mobilization effect
of the both above mentioned preparation on 15 persons suffering from lead
poisoning and increased lead resorption respectively. The lead concentration
of the urine collected for 24 hours was determined for three days. On the
1st day the patients were not treated, on the 2nd one 3×300 mg penicillamine
p. os (Byanodine® caps), but on the third 2 g CaNa2EDTA
in iv. infusion was administered. The mean value of the lead excretion
in urine was 908 (180–5000) µg/l after administration of penicillamine,
but 3326 (300–16,000) after CaNa2EDTA infusion. The mean value
of the lead excretion in the urine was three times higher after administration
of penicillamine, but 11× higher after administration of CaNa2EDTA
than the one without provocation. Consequently the lead mobilisating effect
of the CaNa2EDTA proved 3,7× higher than that of the penicillamine.
The daily cost of the treatment in case of the penicillamine is 4×
lower than that of the CaNa2EDTA, but the duration of healing
is 4× longer. So the expenses are practically identical, but the
p. os therapy is of course much simplier. Authors propose the treatment
with CaNa2EDTA in cases of intoxication, but the one with penicillamin
in case of symptomm-free persons with increased lead resorption.
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