The efficacy of chelation therapy and factors influencing mortality in lead intoxicated petrol sniffers

Burns, C. B.; Currie, Bart J.

doi:10.1111/j.1445-5994.1995.tb01521.x

Cited by 19 publications

(8 citation statements)

References 15 publications

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“…It was previously seen that administration of D-P should be continued for more than two months to cause significant reduction in blood Pb (González-Ramírez et al and Shannon & Townsend). Another study on petrol sniffers showed that urinary excretion of Pb did not increase appreciably after administration of D-P (Burns & Currie, 1995). In our study , no obvious differences were observed between recovery and treatment groups after D-P treatment.…”

Section: Discussionmentioning

confidence: 34%

Effect of Lead Intoxication and D-Penicillamine Treatment on Hematological Indices in Rats

Golalipour

Roshandel

et al. 2007

Int. J. Morphol.

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SUMMARY:Lead is one of the most important environmental pollution which is toxic to many organ systems. D-penicillamine (D-P) is a chelator drug which is used for treatment of lead toxicity for several years. This study was conducted in order to evaluate the efficacy of D-P in reducing the effects of lead on hematological indices. This study was done on 36 male adult, 6-8 weeks albino Wistar rats in Gorgan University of Medical Sciences. At first male adult rats were exposed to lead acetate in their drinking water. After 8 weeks, 6 rats were selected and blood samples were prepared to assess the effects of lead toxicity. The remained lead exposed rats were divided into recovery and treatment groups where distilled water and D-P was administered for them, respectively. After lead exposure, red blood cell count increased slightly, but hemoglobin and hematocrite were decreased. Also MCV and MCH were significantly decreased (P<0.05). RDW, PDW and MPV were significantly higher in lead exposed rats (P<0.05). After recovery period, most of parameters were close to normal while there were no significant differences between recovery and treatment groups. This study showed that hematologic effects of lead are reversible and D-P administration do not play an important role in subchronic lead intoxication.

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Section: Discussionmentioning

confidence: 34%

Effect of Lead Intoxication and D-Penicillamine Treatment on Hematological Indices in Rats

Golalipour

Roshandel

et al. 2007

Int. J. Morphol.

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“…Chronic tetraethyl lead intoxication from huffing leaded gasoline has also been treated with BAL and EDTA resulting in blood lead level reductions similar to endogenous clearance alone [8,14]. In one series of patients with neurotoxicity from huffing gasoline, treatment with BAL and EDTA and was reported to decrease whole blood lead concentrations during therapy [15]. The theoretic utility of chelation therapy would be to bind a small percentage of biotransformed inorganic lead; however, this therapy is of unproven clinical efficacy and is generally not recommended.…”

Section: Discussionmentioning

confidence: 99%

“…The pathophysiology in these cases may be different due to chronic, repeated exposures as well as the presence of other hydrocarbons which could contribute to encephalopathy. It is also common in patients who huff leaded gasoline to develop chronic neuropsychiatric symptoms [7,8,14,15]. The only series of acute oral ingestion of tetraethyl lead described two fatalities from small volume intentional exposures [3].…”

Section: Discussionmentioning

confidence: 99%

Severe Neurotoxicity Following Ingestion of Tetraethyl Lead

et al. 2010

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Organic lead compounds are potent neurotoxins which can result in death even from small exposures. Traditionally, these compounds are found in fuel stabilizers, anti-knock agents, and leaded gasoline. Cases of acute organic lead intoxication have not been reported for several decades. We report a case of a 13-year-old Iraqi male who unintentionally ingested a fuel stabilizer containing 80-90% tetraethyl lead, managed at our combat support hospital. The patient developed severe neurologic symptoms including agitation, hallucinations, weakness, and tremor. These symptoms were refractory to escalating doses of benzodiazepines and ultimately required endotracheal intubation and a propofol infusion. Adjunctive therapies included chelation, baclofen, and nutrition provided through a gastrostomy tube. The patient slowly recovered and was discharged in a wheelchair 20 days after ingestion, still requiring tube feeding. Follow-up at 62 days post-ingestion revealed near-resolution of symptoms with residual slurred speech and slight limp. This case highlights the profound neurotoxic manifestations of acute organic lead compounds.

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“…Lead encephalopathy arising from leaded petrol inhalation is additionally characterized by seizures or even death, and requires emergency and intensive hospital treatment (Boeckx, Posti, & Coodin, 1977;Cairney et al, 2004a;Coulehan et al, 1983;Goodheart & Dunne, 1994;Seshia, Rajani, Boeckx, & Chow, 1978). Treatment for these individuals involves chelation therapy to reduce symptom severity and blood lead levels by mobilizing inorganic lead for excretion, although residual neurological impairments may persist (Burns & Currie, 1995;Cairney et al, 2004a).…”

Section: Introductionmentioning

confidence: 98%

Recovery from Central Nervous System Changes Following Volatile Substance Misuse

Dingwall

Cairney

2011

Substance Use & Misuse

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This review examines cognitive, neurological, and neuroanatomical recovery associated with abstinence from volatile substance misuse (VSM). Articles describing functional or structural brain changes longitudinally or cross-sectional reports comparing current and abstinent users were identified and reviewed. A significant lack of empirical studies investigating central nervous system recovery following VSM was noted. The few case reports and group studies identified indicated that cognitive and neurological impairments appear to follow a progression of decline and progression of recovery model, with the severity of impairment related to the duration and severity of misuse, blood lead levels among leaded petrol misusers, and the duration of abstinence for recovery. By contrast, severe neurological impairment known as lead encephalopathy from sniffing leaded petrol occurred as more catastrophic or abrupt damage to cerebellar processes that may never fully recover. Neuroanatomical damage may not recover even with prolonged abstinence.

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The efficacy of chelation therapy and factors influencing mortality in lead intoxicated petrol sniffers

Cited by 19 publications

References 15 publications

Effect of Lead Intoxication and D-Penicillamine Treatment on Hematological Indices in Rats

Effect of Lead Intoxication and D-Penicillamine Treatment on Hematological Indices in Rats

Severe Neurotoxicity Following Ingestion of Tetraethyl Lead

Recovery from Central Nervous System Changes Following Volatile Substance Misuse

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